Akademik Gastroenteroloji Dergisi最新文献

{"title":"Gastrointestinal nöroendokrin tümörlerde GLP-2 reseptör ekspresyonunun değerlendirilmesi","authors":"Süleyman Koç, Özgül Sağol, Mesut Akarsu","doi":"10.17941/agd.1349571","DOIUrl":"https://doi.org/10.17941/agd.1349571","url":null,"abstract":"Evaluation of GLP-2 receptor expression in gastrointestinal neuroendocrine tumors \u0000Background and Aims: Neuroendocrine tumors arise from cells of the neuroendocrine system. These cells show both nerve and endocrine cell characteristics and can be found in many organs in the body. GLP-1 and GLP-2 are released from intestinal L cells in a 1:1 ratio following food intake. GLP-2 receptor recognizes GLP-2. GLP-2 receptor mRNA transcripts have been detected in the stomach, small and large intestine, brain, and lung. The proliferative effect of GLP-2 has been demonstrated in mice, rats, pigs, and humans by administering exogenous GLP-2. The objective is to evalaute the relation between gastroenteropancreatic neuroendocrine tumors and glukagon like peptid-2 and GLP-2 receptor. Materials and Methods: The patients, who were pathologically diagnosed with gastroenteropancreatic neuroendocrine tumor between 2006-2009 were included in the study. There were 47 patients (27 females, 20 males, avarage age: 54 ± 15.5) in the study. There were also 46 control group patients (25 females, 21 males, avarage age: 57.5 ± 14.8). Pathological tissue blocks prepared on poly-L-lysine microscope slides were stained by GLP-2 receptor antibody (1:100 - 1:200, 1 mg/ml) immunohistochemical stain. Results: GLP-2 receptor positivity of colon neuroendocrine tumor group was 30% (4/13) and colon control group was %100. GLP-2 receptor positivity of pancreas neuroendocrine tumor group was 25% (3/12) while it was 100% in pancreas control group. The comparison of colon neuroendocrine tumor and control group showed significant difference (p: 0.003). The comparison of pancreas neuroendocrine tumor and control group also showed statistically significant difference (p < 0.001). The comparison of gastric neuroendocrine tumor with the control yielded comparable results (p: 0.22). Conclusions: We concluded that GLP-2 receptor cannot be as useful as somatostatin receptors in diagnosis and treatment of these tumors. More studies are needed on this subject with different methods.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127064027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pankreatik psödokistlerde tanısal yöntemlerin performansı","authors":"Yavuz Özden","doi":"10.17941/agd.1222894","DOIUrl":"https://doi.org/10.17941/agd.1222894","url":null,"abstract":"Giriş ve Amaç: Pankreas kistik lezyonlarının tedavisini yönetmek çoğu zaman klinisyen için zordur. Bu nedenle ayırıcı tanı yapılması için öykü, klinik, laboratuvar, radyolojik görüntüleme, endoskopik ultrasonografi, endoskopik ultrasonografi - ince iğne aspirasyon biyopsisi ile alınan kist sıvı analizi ve sitopatoloji verilerinin değerlendirilmesi önemlidir. Endoskopik ultrasonografi ile saptanan pankreatik psödokistlerin yönetiminde görüntüleme yöntemlerinin performansını ve endoskopik ultrasonografi eşliğinde endoskopik drenaj işlemi yaptığımız hastaların klinik özelliklerini çalışmamızda inceledik. Gereç ve Yöntem: Çalışmamızda Temmuz 2009-Ocak 2018 tarihleri arasında Dokuz Eylül Üniversitesi Tıp Fakültesi Hastanesi İç Hastalıkları Anabilim Dalı Gastroenteroloji Kliniği Endoskopi Ünitesinde pankreas kisti nedeniyle endoskopik ultrasonografi yapılan 18 yaş üstü hastalar retrospektif olarak değerlendirilmiştir. Endoskopik ultrasonografi ve/veya endoskopik ultrasonografi - ince iğne aspirasyon biyopsisi değerlendirilmesi sonucu Atlanta klasifikasyonuna göre pankreatik psödokist tanısı alan 102 hasta çalışmaya dahil edilmiştir. Hastaların demografik verileri, klinik özellikleri, laboratuvar verileri, radyolojik/endoskopik ultrasonografi görüntü raporları ve patolojik inceleme sonuçları retrospektif olarak değerlendirilmiştir. Bulgular: Radyolojik açıdan pankreas kistlerini, psödokist olarak ayırma yüzdesi bilgisayarlı tomografi için %58.3, magnetik rezonans için %70.5, endoskopik ultrasonografi için %84.3, endoskopik ultrasonografi + ince iğne aspirasyon biyopsisi için ise %100 olarak saptanmıştır. Tanısal performans olarak bilgisayarlı tomografi %47.5, magnetik rezonans %63.1, endoskopik ultrasonografi %78.4, endoskopik ultrasonografi + ince iğne aspirasyon biyopsisi %95 olarak saptanmıştır. Pankreatik psödokist tanılı 102 hastadan, 36’sına drenaj işlemi uygulanmıştır. Drenaj işlemi uygulanan 36 hastanın, 35’inde tam rezolüsyon, 1 hastada kısmi rezolüsyon sağlanmıştır. Drenaj işlemi uygulanan ve uygulanmayan hastalar arasında yaş, cinsiyet, kistin lokalizasyonu, serum C reaktif protein, serum amilaz, kist amilaz, kist karsinoembriyonik antijeni, kist karbonhidrat antijen 19-9 düzeyleri kıyaslandığında anlamlı farklılık elde edilememiştir. Sonuç: Pankreatik psödokistlerin tanısında ve izleminde bilgisayarlı tomografi ve magnetik rezonansa kıyasla endoskopik ultrasonografi ve endoskopik ultrasonografi - ince iğne aspirasyon biyopsisi daha yüksek tanısal duyarlılığa sahiptir. Buna rağmen %15’e varan oranda endoskopik ultrasonografi ve endoskopik ultrasonografi - ince iğne aspirasyon biyopsisi neoplastik/benign kist ayrımını yapmada yeterli olamamaktadır. Günümüzde pankreatik psödokistlerde endoskopik drenaj zamanlaması ile ilgili bir fikir birliği bulunmamaktadır. Bizim uyguladığımız endoskopik ultrasonografi eşliğinde drenaj işlemlerindeki yüksek başarı ve düşük komplikasyon oranları bize hastaların büyük bir kısmı için bu yöntemin uygun olduğunu v","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121893539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humerus metastasis of hepatocellular carcinoma: A rare case report","authors":"Şehmus Ölmez, B. Sarıtaş, Özgür Külahçı, G. Söker, O. Çiloğlu","doi":"10.17941/agd.1223635","DOIUrl":"https://doi.org/10.17941/agd.1223635","url":null,"abstract":"Hepatocellular carcinoma is the most common primary liver tumor. Hepatocellular carcinoma usually makes metastasis to bones. Prognosis of bone metastasis of hepatocellular carcinoma is becoming better with early diagnosis and improvements in treatment modalities. As survival increases, bone metastasis is faced more. However, humerus metastasis is very rare. Bone metastasis may result in symptoms and pathologic fractures. Hepatocellular carcinoma metastasis of bone worsens patients’ quality of life. Early diagnosis and proper treatment are very important. Herein we report a rare case with humerus metastasis of hepatocellular carcinoma which is treated with resection and endoprosthesis.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116483523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The changing non-invasive fibrosis index value in patients with hepatitis C treated with direct-acting antiviral agents","authors":"D. Arı, H. Gökcan","doi":"10.17941/agd.1222901","DOIUrl":"https://doi.org/10.17941/agd.1222901","url":null,"abstract":"Background and Aims: About 400 000 patients with hepatitis C virus die from cirrhosis-related complications and hepatocellular carcinoma every year. Direct-acting antivirals provide a sustained virologic response in more than 90% of patients with hepatitis C virus infection. We aimed to evaluate the alteration of the non-invasive fibrosis index in patients with hepatitis C virus who were treated with direct-acting antivirals. Materials and Method: Patients with hepatitis C virus who received a complete course of direct-acting antivirals were analyzed. FIB-4 and APRI were calculated for each patient. Results: Of the 88 patients, 46 (52%) were males, and 21 (23.8%) were cirrhotics. The mean age was 58 years. The significant decrease was showed in the non-invasive scores compared from the baseline to the end of treatment. There was a statistically significant drop in mean FIB-4 and APRI scores from baseline to post sustained virologic response (p < 0.001). In the long-term follow-up, it was observed to continue low FIB-4 and APRI at 15 months post sustained virologic response. Mean follow up-time was 27.8 ± 24.3 months in our study, and just one patient was diagnosed with hepatocellular cancer after direct-acting antivirals treatment during follow-up. Conclusion: An early decline in FIB-4 and APRI scores can be related to a decrease in liver enzymes. Nonetheless, maintaining a low level of non-invasive markers has been linked to a reduction in necroinflammation.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126636430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whipple hastalığı ve multiple myelom birlikteliği: nadir bir olgu sunumu","authors":"Azar Abi̇yev","doi":"10.17941/agd.1222985","DOIUrl":"https://doi.org/10.17941/agd.1222985","url":null,"abstract":"Whipple hastalığı, ağırlıklı olarak gastrointesinal sistemi etkilemekle birlikte birçok sistemi tutabilen, nadir görülen enfeksiyöz bir hastalıktır. Whipple hastalığının immünsupresyon ile ilişkili olduğu düşünülse de, bu konuda net bir bilgi yoktur. Aynı zamanda hematolojik malignitelerde Whipple hastalığının görüldüğüne dair herhangi bir vaka rapor edilmemiştir. Whipple hastalığı ve multiple myelomun birlikte görüldüğü nadir bir vakadan bahsedeceğiz.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121433316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parkinson hastalarında perkütan endoskopik gastrojejunostomi katateri takılan hastalarımızın takibi: Tek merkez deneyimi","authors":"Nurten TÜRKEL KÜÇÜKMETİN, Tevfik Solakoğlu","doi":"10.17941/agd.1215967","DOIUrl":"https://doi.org/10.17941/agd.1215967","url":null,"abstract":"Giriş Ve Amaç: Perkütan endoskopik gastrostomi ve perkütan endoskopik gastrojejunostomi enteral nutrisyonda sık kullanılan yöntemlerdir. Son yıllarda ileri evre Parkinson Hastalığı tedavisinde, Levodopa/Karbidopa intestinal jel, perkütan endoskopik gastrojejunostomi ile uygulanmaktadır. Biz, burada Parkinson Hastalığı tedavisi için pull tekniği ile perkütan endoskopik gastrojejunostomi katateri yerleştirilen hastalarımızın takiplerini sunmayı amaçladık. Gereç ve Yöntem: Mayıs 2019 - Mart 2022 yılları arasında perkütan endoskopik gastrojejunostomi takılan 11 hasta incelendi, hastalara ait demografik veriler, işlem sonrası komplikasyonları ve işlem tekrarları değerlendirildi. Bulgular: Perkütan endoskopik gastrojejunostomi takılan hastaların 1’i (%9) kadın, 10’u erkek (%91), yaş ortalaması 63.5 ± 11.2 olup en genç hasta 43 ve en yaşlı hasta 78 yaşındaydı. Onbir hastaya perkütan endoskopik gastrojejunostomi takılması, perkütan endoskopik gastrostomi ve jejunal tüp değişimi olmak üzere toplam 23 endoskopik işlem uygulandı. İlk perkütan endoskopik gastrojejunostomi takılması sonrasında perkütan endoskopik gastrojejunostomi seti ve/veya sadece jejunal katater replasmanı arasındaki ortalama süre 310.5 ± 252.3 gün iken en kısa süre 60 gün, en uzun süre 674 gündü. Replasmanlar arasındaki en kısa süre 26 gün iken, en uzun süre 641 gündü. Hiçbir hastada akut ya da majör komplikasyon görülmezken, jejunal katater tıkanması (3’ü ilaç ile, 1’i king olması) %28.5 oranında en fazla görülen minör komplikasyon olmuştur. Bunu sırasıyla %21.4 (3 olgu) stoma enfeksiyonu, %14.2 (2 hasta) perkütan endoskopik gastrostomi aşınması, %14.2 (2 hasta) jejunal tüpün yanlışlıkla çekilmesi, %7.1 perkütan endoskopik gastrostomi tıkanması (n=1) ve %7.1 (n=1) perkütan endoskopik gastrojejunostomi setinin çekilmesi izlemiştir. Ondört adet toplam advers olay bildirilmiştir. Sonuç: Perkütan endoskopik gastrojejunostomi yerleştirme ve değiştirmesi güvenli bir prosedürdür, ancak perkütan endoskopik gastrojejunostominin uzun süreli kullanımını ve dayanıklılığını araştıran çok az veri bulunmaktadır, replasman için en iyi zamanı ve uzun süreli klinik sonuçları gösteren prospektif çalışmalara ihtiyaç vardır.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131211746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic compression method in the treatment of post-transplant biliary stricture: A case report","authors":"Azar Abiyev, Harun Küçük, Seçkin Özgül, Serkan Dumanli, Gülden Bi̇li̇can, Mehmet Koray Akkan, Murat Keki̇lli̇","doi":"10.17941/agd.1336263","DOIUrl":"https://doi.org/10.17941/agd.1336263","url":null,"abstract":"Cerrahi tekniklerdeki gelişmelere rağmen biliyer komplikasyonlar hala yaygındır ve karaciğer nakli sonrasında hasta sağkalımını etkilemektedir. Biliyer darlıklar, genellikle endoskopik retrograd kolanjiyopankreatografi ve perkütan transhepatik kolanjiyografi ile tedavi edilmektedir. Bununla birlikte, biliyer anastomozun tam darlığı durumlarında, cerrahi yeniden anastomoz bir tedavi seçeneğidir. Ancak yeniden anastomoz için cerrahi prosedürler invazivdir ve postoperatif adezyon ve hastaların genel durumu nedeniyle uygulanması zordur. Manyetik kompresyon yöntemi, endoskopik retrograd kolanjiyopankreatografi ve perkütan transhepatik kolanjiyografi ile tedavi edilemeyen olgularda, cerrahi gerektirmeyen güvenli bir anastomoz yöntemidir. Burada, canlı donör karaciğer transplantasyonundan sonra manyetik kompresyon yöntemi ile başarılı şekilde tedavi edilen bir olguyu sunuyoruz.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126951727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of insulin resistance on the severity of acute pancreatitis","authors":"E. Keskin","doi":"10.17941/agd.1134955","DOIUrl":"https://doi.org/10.17941/agd.1134955","url":null,"abstract":"Background and Aims: Acute pancreatitis is inflammation of the pancreas due to various causes. Insulin resistance is an important component of the metabolic syndrome and causes a chronic inflammatory condition, so it may affect disease severity in acute pancreatitis patients. In our study, we aimed to investigate the relationship of insulin resistance with acute pancreatitis severity and to compare it with other prognostic factors. Materials and Methods: In our study, 84 patients hospitalized in the clinic with a diagnosis of acute pancreatitis were evaluated. Our study was designed prospectively. To determine the severity of acute pancreatitis, the Atlanta Classification, Bedside Index of Severity in Acute Pancreatitis score, Imrie score, Ranson score, and Balthazar score were determined using the laboratory and imaging findings of the patients. The 'Homeostasis Model Assessment of Insulin Resistance' score was used to evaluate insulin resistance in patients. Accordingly, it was investigated whether there was a difference between the groups with and without insulin resistance in terms of disease severity. Results: 45.2% of the patients were in the group with insulin resistance. According to the Atlanta classification, 6 patients (7.1%) were evaluated as severe acute pancreatitis. 4 patients were evaluated as severe acute pancreatitis because of the development of prerenal acute kidney injury and 2 patients due to sepsis and need for intensive care. In the Receiver Operating Characteristic analysis performed in terms of disease severity, Balthazar and the 'Bedside Index of Severity in Acute Pancreatitis' score were found to be strong in determining the prognosis of the patients (Area Under the Curve; 0.955 and 0.979, respectively). When the 'Bedside Index of Severity in Acute Pancreatitis' and Balthazar scores of the group with insulin resistance were compared with the group without insulin resistance, a statistically significant difference was found (p = 0.019 and p = 0.013, respectively). Conclusion: The high 'Bedside Index of Severity in Acute Pancreatitis' and Balthazar scores in our study in acute pancreatitis patients with insulin resistance suggest that the presence of insulin resistance can be used as a prognostic factor for severe acute pancreatitis.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131262870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kolorektal adenoma ve karsinomlu hastalarda metabolik ve inflamatuvar risk faktörlerinin değerlendirilmesi","authors":"Ezgi Karahan, Zeynep GÖK SARGIN, Yücel Üstündağ","doi":"10.17941/agd.1150314","DOIUrl":"https://doi.org/10.17941/agd.1150314","url":null,"abstract":"Background and Aims: Metabolic syndrome and its related components are thought to be risk factors for developing colorectal neoplasms due to hyperinsulinemia, insulin resistance, and oxidative stress resulting in chronic low-grade inflammation. This study aims to explain the association of colorectal neoplasms (colon adenocarcinoma and colon adenoma) with metabolic syndrome components, non-alcoholic fatty liver disease, and inflammatory markers. Materials and Methods: Data of 151 patients diagnosed with colon adenoma and colorectal adenocarcinoma were retrospectively reviewed. Demographic characteristics, routine blood tests, colonoscopic findings, pathology results, tumor-node-metastasis stages of colorectal adenocancer, and hepatic ultrasonography findings were recorded. The Homeostatic Model Assessment for Insulin Resistance scores were calculated. Results: The study cohort consisted of 71 patients with adenoma and 80 patients with colorectal adenocancer. The number of patients with diabetes mellitus, hypertension, hypertriglyceridemia, metabolic syndrome, severe liver steatosis was significantly higher in the colorectal adenocancer group compared to the colorectal adenoma group. Additionally, neutrophil-lymphocyte ratio, C-reactive protein, and C-reactive protein to albumin ratio were significantly higher in the colorectal adenocancer group compared to the adenoma group. In univariant analysis, patients with diabetes mellitus, hypertension, hypertriglyceridemia, metabolic syndrome, severe liver steatosis were found to have a shorter duration of survival than those who did not have these risk factors. In multivariate analysis, advanced tumor-node-metastasis stage, severe hepatosteatosis, hypertension, and hypertriglyceridemia were found to be independent risk factors for survival of the patients with colorectal adenocancer. Conclusions: Metabolic syndrome, severe liver steatosis, and inflammatory process may be risk factors for the transition from colon adenoma to adenocarcinoma and shorter survival in colorectal cancer patients.","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"444 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122733582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can the scoring used in liver diseases be used to differentiate malignant and benign cholestasis?","authors":"Yusuf Bünyamin Ketenci, U. Avcıoğlu","doi":"10.17941/agd.1163842","DOIUrl":"https://doi.org/10.17941/agd.1163842","url":null,"abstract":"Bacground and aim: Chronic biliary tract diseases impair hepatocyte functions by causing longer exposure to bilirubin in hepatocytes and toxins excreted from the liver. In addition, there are publications suggesting that biliary tract malignancies, like primary malignancies of the liver, are also characterized by fibrosis. In the light of this information, it can be thought that cholestatic diseases that cause chronic and malignant bile duct obstruction worsen liver functions and increase liver fibrosis than diseases that cause acute and benign biliary tract obstruction. In our study, we aimed to investigate which scoring systems used in liver diseases (R-factor, the model for end-stage liver disease-natrium, albumin-bilirubin score, alkaline phosphatase-to-platelet ratio, aspartate aminotransferase to platelet ratio index, fibrosis-4 score \u0000 and gamma-glutamyl transpeptidase-to-platelet ratio) could be used as an auxiliary method in the diagnosis of malignant cholestasis. Material and Method: The files of patients who were diagnosed with obstructive cholestasis in Ondokuz Mayıs University Faculty of Medicine, Gastroenterology Clinic between July 2017 and July 2021 were reviewed retrospectively. Patients diagnosed with acute and benign cholestasis were classified as Group 1, and patients with chronic and malignant cholestasis were classified as Group 2. Using the laboratory values of the patients at the time of first application; R-factor, the model for end-stage liver disease-natrium, albumin-bilirubin score, alkaline phosphatase-to-platelet ratio, aspartate aminotransferase to platelet ratio index, fibrosis-4 score and gamma-glutamyl transpeptidase-to-platelet ratio scores were calculated, and the relationship between their diagnosis and their scores at the time of diagnosis was evaluated. Results: A total of 202 patients, 116 male (57.4%) and 86 female (42.6%), were included in the study. There were 92 (45.5%) patients in Group 1 and 110 (54.5%) patients in Group 2. There was no significant difference between Group 1 and Group 2 in terms of demographic characteristics. Common diseases were cholangitis, choledocholithiasis, biliary sludge and biliary pancreatitis in Group 1, and pancreatic head carcinoma in Group 2, respectively. Among the laboratory parameters, alkaline phosphatase, total and direct bilirubin were the most important tests indicating malignancy (p < 0.001). Among the liver disease scores; R-factor (p < 0.001), the model for end-stage liver disease-natrium (p < 0.001) and albumin-bilirubin score (p = 0.023) were significant in favor of Group 2, while alkaline phosphatase-to-platelet ratio (p < 0.001), aspartate aminotransferase to platelet ratio index (p < 0.001) and fibrosis-4 score (p < 0.001) were significant in favor of Group 1, but there was no significant difference between the two groups in terms of gamma-glutamyl transpeptidase-to-platelet ratio (p = 0.242). The final diagnosis of the patients in Group 1 was mostly made ","PeriodicalId":118745,"journal":{"name":"Akademik Gastroenteroloji Dergisi","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115339448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}