2011-2021 arasında ülseratif kolit tanısı konulan hastalarda tanı anındaki tutulum yeri, premalign lezyonlar ve mayo skorunun retrospektif olarak değerlendirilmesi
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Date
2022
Authors
Çağatay, Cüneyt
Journal Title
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Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Ülseratif kolit kolonda kesintisiz mukoza tutulumu yapan, aktivasyon ve remisyonlarla seyreden kronik inflamatuar bir bağırsak hastalığıdır. Hastalarda en sık görülen şikayetler karın ağrısı, ishal ve rektal kanamadır. Gastrointestinal semptomların yanında tüm vücudu tutabilen çeşitli ekstraintestinal bulgular sıklıkla görülebilir. Hastalığın şiddeti ve süresi ile kolorektal kanser insidansında artış görülmektedir. Takip ve tedavide hem medikal hem cerrahinin yeri vardır. Çalışmamızın amacı hastaların epidemiyolojik olarak incelenmesi, premalign lezyonlarının ve kolorektal kanser insidansının tespit edilmesi ve bu veriler arasındaki ilişkinin araştırılmasıdır. Ayrıca klinik araştırmalarda kullanılmak üzere, hastanın genel durumu ve prognozunu değerlendirmek için geliştirilen Mayo skorlama sisteminin kullanılarak hastaların Mayo skorunun hesaplanması ve bu ölçeğin diğer veriler ile ilişkisinin değerlendirilmesidir. Çalışmamızda 1 Ocak 2011 ile 31 aralık 2021 tarihleri arasında Bursa Uludağ Üniversitesi Tıp Fakültesi Gastroenteroloji bölümüne başvuran ve ülseratif kolit tanısı konulan 535 kişinin verileri toplandı. Ancak veri yetersizliği nedeniyle 375 hasta çalışmaya dahil edilemedi. Çalışmanın kriterlerine uyan ve yeterli verisi bulunan 160 hasta cinsiyet, tanı yaşı, ekstraintestinal bulgular, polip ve poliplerin patolojik alt tipleri, kolektomi, mayo skoru ve kolorektal karsinom gelişimi açısından retrospektif olarak incelendi. Çalışmamızda 3 farklı kıtadan yapılan yayınlar ile verilerimizi kıyasladık. Epidemiyolojik olarak erkek hasta oranı daha fazla olmasına rağmen hastaların medyan tanı yaşı avrupa verileri ile korele bulundu. Yaptığımız analizlerde ekstra intestinal bulgu insidansının diğer ülkeler ile benzer olduğunu tespit ettik. Çalışmamızdaki hastaların mayo skoru diğer çalışmalara göre daha yüksek tespit edilirken, kolorektal kanser ve kolektomi oranlarının mayo skorundaki artış ile arasındaki anlamlı ilişki literatür ile uyumlu bulundu.
Ulcerative colitis is a chronic inflammatory bowel disease with continuous mucosal involvement in the colon that has a course of flares and remissions. Most common complaints in patients are abdominal pain, diarrhea and rectal bleeding. Extra-intestinal manifestations could often be seen. An increase in the incidence of colorectal cancer could be seen with disease severity and duration. Treatment and surveillance consists of both medical and surgical intervention. The purpose of our study was to investigate our patient epidemiology, the incidence of premalignant lesions and colorectal cancer and the relationship of this data in comparison to one another. Moreover the Mayo Scoring system, created to be used in clinical trials as a means to evaluate patients current state and prognosis, was used to calculate each patient's Mayo Score and compared it to the patients' other data for a meaningful correlation. Our study was conducted on 535 patients who came to Bursa Uludag University Faculty of Medicine Department of Gastroenterology between January 1, 2011 and December 31,2021 and were diagnosed with ulcerative colitis. However 375 patients were excluded from the study due to insufficient data. 160 patients were had sufficient data and thus suitable criteria to be included in the study and these patients were inspected retrospectively for gender, age of diagnosis, extra-intestinal manifestations, presence of polyps and their pathological subtypes, colectomy, Mayo Score and the development of colorectal cancer. The data obtained from our study was compared to publications from 3 different continents. Although epidemiologically our male patient ratio was higher, the patients age of diagnosis was found to correlated to European data. In our analysis, we found that the incidence of extra-intestinal findings was similar to other countries. While the Mayo Scores were obtained from our data were found to be higher compared to other studies, the rate of increase in the Mayo score compared to colectomy rates and colorectal carcinoma rates were consistent with other literature.
Ulcerative colitis is a chronic inflammatory bowel disease with continuous mucosal involvement in the colon that has a course of flares and remissions. Most common complaints in patients are abdominal pain, diarrhea and rectal bleeding. Extra-intestinal manifestations could often be seen. An increase in the incidence of colorectal cancer could be seen with disease severity and duration. Treatment and surveillance consists of both medical and surgical intervention. The purpose of our study was to investigate our patient epidemiology, the incidence of premalignant lesions and colorectal cancer and the relationship of this data in comparison to one another. Moreover the Mayo Scoring system, created to be used in clinical trials as a means to evaluate patients current state and prognosis, was used to calculate each patient's Mayo Score and compared it to the patients' other data for a meaningful correlation. Our study was conducted on 535 patients who came to Bursa Uludag University Faculty of Medicine Department of Gastroenterology between January 1, 2011 and December 31,2021 and were diagnosed with ulcerative colitis. However 375 patients were excluded from the study due to insufficient data. 160 patients were had sufficient data and thus suitable criteria to be included in the study and these patients were inspected retrospectively for gender, age of diagnosis, extra-intestinal manifestations, presence of polyps and their pathological subtypes, colectomy, Mayo Score and the development of colorectal cancer. The data obtained from our study was compared to publications from 3 different continents. Although epidemiologically our male patient ratio was higher, the patients age of diagnosis was found to correlated to European data. In our analysis, we found that the incidence of extra-intestinal findings was similar to other countries. While the Mayo Scores were obtained from our data were found to be higher compared to other studies, the rate of increase in the Mayo score compared to colectomy rates and colorectal carcinoma rates were consistent with other literature.
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Keywords
Ülseratif kolit, Mayo skoru, Kolorektal karsinom, Ulcerative colitis, Mayo score, Colorectal carcinoma
Citation
Çağatay, C. (2022). 2011-2021 arasında ülseratif kolit tanısı konulan hastalarda tanı anındaki tutulum yeri, premalign lezyonlar ve mayo skorunun retrospektif olarak değerlendirilmesi. Yayınlanmamış tıpta uzmanlık tezi. Bursa Uludağ Üniversitesi Tıp Fakültesi.