In patients with neuroendocrine cell hypeplasia and h. pylori combination detected at gastric endoscopic biopsy, investigation of the existence of neuroendocrine cell hyperplasia by control endoscopy after h.pylori eradication treatment

Objectives: We aimed to determine the relationship between neuroendocrine cell hyperplasia and H. Pylori by detecting the presence of NECH in control endoscopies in patients with neuroendocrine cell hyperplasia and H. Pylori coexistence who received H. Pylori eradication therapy. NECH is considered a premalignant lesion, so we aimed to determine whether eradication of H. Pylori is important in preventing neuroendocrine tumor formation. Material and Method: The study was followed up in Akdeniz University Hospital Gastroenterology Department, upper GIS endoscopy was performed between 01.03.2015 - 01.03.2022, and the association of NECH and H.Pylori was found in the pathological examination of gastric biopsy materials, a total of 100 (46 men, 54 women, mean age) 18 years and older. 54± 14.07) patients were included. The pathological data of the patients' first endoscopies and their second endoscopies at least 6 months apart were compared. Statistical method: Conformity of continuous variables to normal distribution was examined by Kolmogorov Smirnov test. Categorical variables in the study were presented with frequency (n) and percentage (%), and continuous variables with mean±standard deviation (SD), median (IQR 25-75) and minimum-maximum values. The Mann Whitney U test was used in comparisons of the mean of two independent groups in which the parametric test assumptions were not met, and the Independent Samples T test was used in the comparisons of the mean of two independent groups in which the assumptions were met. Pearson Chi-square test and Fisher exact test were used in the analysis of categorical variables. Results: In this study, 55% of the patients with NECH and H. Pylori were women, and there was no statistically significant difference. Chronic use of ppi is (62.1%) in patients without H. Pylori after eradication, and 40.5% in patients with H. Pylori after eradication (p=0.033). In patients without NECH after eradication, chronic ppi use was 47.05%, and no statistically significant difference was found. There was no significant difference between the two groups in the use of H2 receptor blockers, NSAIDs and aspirin. The interval between two endoscopies in the group with H. pylori after eradication was 10 months, and it was 11 months in the group without H. pylori, which was similar. While the said period was measured as 9 months in the group with nehh after the indication, this value was determined as 12 months in the group without nehh. When compared with the presence of H. Pylori or the presence of NECH after eradication, the difference in age and gender was not statistically significant. There was no statistically significant difference in age and gender between patients with NECH after eradication and those without NECH. In two patient groups, which emerged according to the incidence of NECH after eradication. There was no statistical difference in the scope of the drugs used and the presence of allergy history. After eradication, 50% of patients with H. Pylori have nephritis, while 50% do not. On the other hand, 58.6% of the patients without H. Pylori after eradication did not have nehh, while 41.4% had it (p=0.392). Conclusion: There was no significant difference in terms of age and gender in patients with NECH and H. Pylori. In the endoscopies performed after H. Pylori eradication in patients with NECH and H. Pylori, the interval between two endoscopy was 9 months in the group with the presence of NECH, and 12 months in the group without NECH. , in studies to evaluate the improvement of NECH more meaningfully, guided that the interval between two endoscopy should be at least 12 months. Although it is not statistically significant, 58.6% of patients without H. Pylori after eradication do not have NECH, since the number of cases in which NECH regressed after eradication is higher, a comprehensive study with a larger number of patients is needed. Keywords: Neuroendocrine cell hyperplasia, H. pylori, Neuroendocrine tumor