Evaluation of gastric endoscopic biopsy results in accordance with history of previous thyroidectomy
Selahattin Vural1, Ahmet Cumhur Dülger2, Muhammed Ali Ayvaz2, İsmail Aydın1, Tuğrul Kesicioğlu1, Mehmet Gülmez1
1Department of General Surgery, Giresun University Prof. Dr. A. Ilhan Özdemir Training and Research Hospital, Giresun, Turkey
2Department of Gastroenterology, Giresun University Prof. Dr. A. Ilhan Özdemir Training and Research Hospital, Giresun, Turkey
Keywords: Gastric mucosa, intestinal metaplasia, thyroidectomy
Objectives: This study aimed to establish a link between total thyroidectomy and Helicobacter pylori (H. pylori) infection, which is one of the most implicated risk factors that cause gastric intestinal metaplasia (GIM) and is also a risk factor for gastric adenocarcinoma.
Materials and methods: This retrospective study was conducted at Giresun University. We retrospectively reviewed gastric biopsies from 78 thyroidectomized patients (41 males, 37 females; mean age: 64.5±8.5 years; range, 29 to 79 years) in a single center. A control group of 150 subjects (45 males, 105 females; mean age: 59±7.5 years; range, 32 to 78 years) was selected from age-matched dyspeptic subjects with no history of thyroidectomy.
Results: There were no significant differences in baseline sociodemographic characteristics between groups. Histopathological analysis of gastric biopsy specimens showed that the rate of H. pylori infection was found to be significantly lower in the thyroidectomized group (43.3% vs. %60.8; p<0.05). Although in multivariate analysis the relationship between atrophic gastritis and thyroidectomy was not statistically significant (p=0.857), there was a stronger correlation between GIM and thyroidectomy compared to the control group (13.3% vs. 3.3%; p<0.05).
Conclusion: To our knowledge, this is the first study comparing the gastric and endoscopic findings between thyroidectomized patients and those with non-thyroidectomized gastroesophageal reflux disease patients. Further studies are needed to determine a causal link between thyroidectomy and gastric intestinal metaplasia. Evidence has accumulated suggesting that autoimmune thyroid diseases increase the risk of gastric mucosal damage and adversely affect H. pylori status.