Gaitada gizli kan pozitifliği nedeniyle kolonoskopi yapılan hastaların kolonoskopi ve histopatoloji sonuçlarının değerlendirilmesi
Abstract
Giriş ve Amaç: Kolorektal kanser taramasında gaitada gizli kan testi ilk aşamada sıklıkla kullanılan bir testtir. Gaita gizli kan dışında taramada fekal immünohistokimyasal test, sigmoidoskopi ve kolonoskopi gibi yöntemler kullanılmaktadır. Bu çalışmada gaitada gizli kan testi pozitif olması nedeniyle kolonoskopi yapılan hastaların kolonoskopi ve histopatoloji sonuçlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmaya Ocak 2020 ile Aralık 2024 yılları arasında Antalya Eğitim ve Araştırma Hastanesi’nde gaitada gizli kan pozitifliği nedeniyle kolonoskopi yapılan hastalar dahil edildi. Kolon temizliği yetersiz olanlar, bilinen kolorektal kanser öyküsü ve inflamatuar bağırsak hastalığı öyküsü olanlar dışlandıktan sonra dahil edilen hastaların yaşı, cinsiyeti, kolonoskopi sonuçları ve histopatoloji sonuçları not edildi. Bulgular: Çalışmaya toplamda 508 hasta dahil edildi. Hastaların 260’ı (%51.2) erkek, 248’i (%48.8) kadın, medyan yaş 61 (20 - 95), medyan hemoglobin değeri 13.5 (5 - 16.3) g/dl idi. 196 (%38.6) hastanın kolonoskopi bulguları normaldi. Diğer kolonoskopi bulguları; polip 107 (%21.1), inflamatuvar bağırsak hastalığı 70 (%13.8), perianal hastalık 59 (%11.6), kolorektal kanser 31 (%6.1), divertikül 26 (%5.1), ülser 15 (%3), anjiodisplazi 4 (0.8) hasta olarak not edildi. Kolonoskopi neticesinde kolorektal kanser düşünülen ve polip görülen 223 (%43.8) hastadan biyopsi örneği alındı; adenomatöz polip 77 (%34.5), inflamatuvar bağırsak hastalığı 59 (26.5), adenokarsinom 31 (%13.9), hiperplastik polip 26 (%11.7) hastada saptandı. 30 (%13.5) hastada patolojik bulgu görülmedi. Sonuç: Gaita gizli kan testi pozitifliği nedeniyle kolonoskopi yapılan hastaların neredeyse yarısında kolonda bir patoloji tespit edilmiştir. Gaita gizli kan testi kolorektal kanserlerin ve prekanseröz lezyonların tespitinde olduğu gibi, inflamatuvar bağırsak hastalığı, divertikül, perianal hastalık gibi diğer kolon patolojilerinin de tespit edilmesinde kullanılan yol gösterici, kolay uygulanabilir, ucuz bir testtir.
References
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- 5) Kahi CJ, Imperiale TF, Juliar BE, Rex DK. Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol. 2009;7(7):770-5;quiz 711.
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- 7) Yang H, Ge Z, Dai J, Li X, Gao Y. Effectiveness of the immunofecal occult blood test for colorectal cancer screening in a large population. Dig Dis Sci. 2011;56(1):203-7.
- 8) Zouridis S, Sofia D, Alshakhatreh O, et al. Do You Bleed? A 1-Year FOBT Case-Series Study. J Clin Gastroenterol. 2024 Apr 29. Epub ahead of print. PMID: 38668714.
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- 10) Zhao K, Wang S, Yuan Z, et al. The accuracy of the FIT in detecting advanced neoplasm is highest in young people aged 40 to 49 years: an analysis based on sex and age. Int J Colorectal Dis. 2023;38(1):178.
- 11) Nakama H, Zhang B, Fattah AS, Zhang X. Colorectal cancer in iron deficiency anemia with a positive result on immunochemical fecal occult blood. Int J Colorectal Dis. 2000;15(5-6):271-4.
- 12) IJspeert JEG, Bevan R, Senore C, et al. Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview. Gut. 2017;66(7):1225-32.
- 13) Steele RJ, McClements PL, Libby G, et al. Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer. Gut. 2009;58(4):530-5.
- 14) van der Vlugt M, Grobbee EJ, Bossuyt PM, et al. Risk of Oral and Upper Gastrointestinal Cancers in Persons With Positive Results From a Fecal Immunochemical Test in a Colorectal Cancer Screening Program. Clin Gastroenterol Hepatol. 2018;16(8):1237-1243.e2.
Evaluation of colonoscopy and histopathology results in patients undergoing colonoscopy for occult blood positivity in stool
Abstract
Background and Aims: Fecal occult blood test is frequently used as a first-line screening method for colorectal cancer. In addition to fecal occult blood test, other screening methods include fecal immunohistochemical test, sigmoidoscopy, and colonoscopy. This study aims to evaluate the colonoscopy and histopathology results of patients who underwent colonoscopy due to a positive fecal occult blood test. Materials and Methods: This study included patients who underwent colonoscopy due to a positive fecal occult blood test at Antalya Training and Research Hospital between January 2020 and December 2024. Patients with inadequate bowel preparation, a known history of colorectal cancer, or inflammatory bowel disease were excluded. The age, gender, colonoscopy findings, and histopathological results of the included patients were recorded. Results: A total of 508 patients were included in the study, of whom 260 (51.2%) were male and 248 (48.8%) were female, with a median age of 61 years (range: 20 - 95). The median hemoglobin level was 13.5 g/dL (range: 5 - 16.3). Colonoscopy findings were normal in 196 (38.6%) patients. Other findings included polyps in 107 (21.1%), inflammatory bowel disease in 70 (13.8%), perianal disease in 59 (11.6%), colorectal cancer in 31 (6.1%), diverticula in 26 (5.1%), ulcers in 15 (3%), and angiodysplasia in 4 (0.8%) patients. A total of 223 (43.8%) patients with suspected colorectal cancer or polyps underwent biopsy. Histopathological examination revealed adenomatous polyps in 77 (34.5%) patients, inflammatory bowel disease in 59 (26.5%), adenocarcinoma in 31 (13.9%), and hyperplastic polyps in 26 (11.7%) patients, while 30 (13.5%) patients had no pathological findings. Conclusion: Nearly half of the patients who underwent colonoscopy due to a positive fecal occult blood test were found to have colonic pathology. Fecal occult blood test is a simple, cost-effective, and practical test not only for detecting colorectal cancer and precancerous lesions but also for identifying other colonic pathologies such as inflammatory bowel disease, diverticula, and perianal diseases.
References
- 1) Maida M, Macaluso FS, Ianiro G, et al. Screening of colorectal cancer: present and future. Expert Rev Anticancer Ther 2017;17(12):1131-46.
- 2) Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-63.
- 3) Carroll MR, Seaman HE, Halloran SP. Tests and investigations for colorectal cancer screening. Clin Biochem. 2014;47(10-11):921-39.
- 4) Bond JH. Fecal occult blood test screening for colorectal cancer. Gastrointest Endosc Clin N Am. 2002;12(1):11-21.
- 5) Kahi CJ, Imperiale TF, Juliar BE, Rex DK. Effect of screening colonoscopy on colorectal cancer incidence and mortality. Clin Gastroenterol Hepatol. 2009;7(7):770-5;quiz 711.
- 6) van Rossum LG, van Rijn AF, Laheij RJ, et al. Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population. Gastroenterology. 2008;135(1):82-90.
- 7) Yang H, Ge Z, Dai J, Li X, Gao Y. Effectiveness of the immunofecal occult blood test for colorectal cancer screening in a large population. Dig Dis Sci. 2011;56(1):203-7.
- 8) Zouridis S, Sofia D, Alshakhatreh O, et al. Do You Bleed? A 1-Year FOBT Case-Series Study. J Clin Gastroenterol. 2024 Apr 29. Epub ahead of print. PMID: 38668714.
- 9) Keller R, Schätzle A, Flieger D, Christl SU, Fischbach W. Better acceptance of Fecal Occult Blood Test (FOBT) for colorectal cancer screening during hospitalization. Z Gastroenterol. 2003;41(7):655-8.
- 10) Zhao K, Wang S, Yuan Z, et al. The accuracy of the FIT in detecting advanced neoplasm is highest in young people aged 40 to 49 years: an analysis based on sex and age. Int J Colorectal Dis. 2023;38(1):178.
- 11) Nakama H, Zhang B, Fattah AS, Zhang X. Colorectal cancer in iron deficiency anemia with a positive result on immunochemical fecal occult blood. Int J Colorectal Dis. 2000;15(5-6):271-4.
- 12) IJspeert JEG, Bevan R, Senore C, et al. Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview. Gut. 2017;66(7):1225-32.
- 13) Steele RJ, McClements PL, Libby G, et al. Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer. Gut. 2009;58(4):530-5.
- 14) van der Vlugt M, Grobbee EJ, Bossuyt PM, et al. Risk of Oral and Upper Gastrointestinal Cancers in Persons With Positive Results From a Fecal Immunochemical Test in a Colorectal Cancer Screening Program. Clin Gastroenterol Hepatol. 2018;16(8):1237-1243.e2.
Details
| Primary Language | English |
|---|---|
| Subjects | Gastroenterology and Hepatology |
| Journal Section | Articles |
| Authors | |
| Publication Date | April 29, 2025 |
| Submission Date | February 24, 2025 |
| Acceptance Date | April 11, 2025 |
| Published in Issue | Year 2025 Volume: 24 Issue: 1 |
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