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2010, Número 4

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Cir Cir 2010; 78 (4)


Prevalencia de metaplasia intestinal en el cardias gástrico y su relación con cepas virulentas de Helicobacter pylori cagA y vacA

Abdo-Francis JM, Sobrino-Cossío S, Bernal-Sahagún F, Hernández-Guerrero A

Idioma: Español
Referencias bibliográficas: 50
Paginas: 315-321
Archivo PDF: 95.81 Kb.


RESUMEN

Introducción: Helicobacter pylori coloniza el antro gástrico y se asocia con gastritis, úlcera péptica y cáncer gástrico. Recientemente se ha informado su probable relación con esófago de Barrett, metaplasia intestinal del cardias y esofagitis, así como que la presencia de marcadores de daño severo mucoso está asociada con citocinas vacuolizantes (vacA, cagA). Objetivo: identificar Helicobacter pylori en la mucosa del cardias gástrico en pacientes con reflujo gastroesofágico y su relación con el desarrollo de metaplasia intestinal en esa región.
Material y métodos: Estudio descriptivo, observacional, prolectivo y transversal de 120 pacientes: 60 con reflujo y 60 sin reflujo sometidos a estudio endoscópico por otros diagnósticos. Se realizó endoscopia con toma de biopsia de antro y cardias gástrico, histopatología y reacción en cadena de polimerasa para buscar cepas vacuolizantes.
Resultados: Helicobacter pylori se confirmó en 56% de los pacientes estudiados, con 57.5% de sus cepas virulentas (cagA y vacA). No hubo diferencia entre los grupos de estudio en cuanto a la presencia de Helicobacter pylori en el cardias. La metaplasia intestinal en cardias se documentó en 35% de los pacientes. Existió marcada tendencia a metaplasia intestinal en el cardias gástrico en los pacientes con cepas vacuolizantes de Helicobacter pylori, sin relación con el reflujo gastroesofágico.
Conclusiones: Los resultados sugieren que la presencia de cepas vacuolizantes de Helicobacter pylori en la mucosa del cardias gástrico puede ser un factor de riesgo para el desarrollo de metaplasia intestinal en esa región.


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