Mohar A, Ley C, Guarner J, Herrera-Goepfert R, Sánchez L, Halperin D, Parsonnet J

Idioma: Español
Referencias bibliográficas: 40
Paginas: 405-410
Archivo PDF: 44.54 Kb.

RESUMEN

El cáncer de estómago es la segunda causa de muerte en pacientes que fallecen por tumores malignos en México. Esta enfermedad representa un grave problema de salud pública. Existe una fuerte asociación entre la infección crónica por Helicobacter pylori y el cáncer gástrico. Este tumor es precedido por lesiones preneoplásicas incluyendo gastritis crónica atrófica (GCA), metaplasia intestinal (MI) y displasia. El objetivo fue conocer la prevalencia de lesiones precursoras de cáncer gástrico asociadas a la infección por Helicobacter pylori en el estado de Chiapas, y su erradicación con antibióticos. Por serología para la proteína CagA y niveles séricos de gastrina se identificó a personas con infección por Helicobacter pylori y GCA. Se practicó endoscopia basal, seis semanas y un año después, con toma de biopsia. Participaron 281 personas, asignadas aleatoriamente al grupo de tratamiento o placebo. Se encontró GCA en 59%, MI en el 51% y displasia en el 13%. En el análisis-de-intención y por-protocolo se eliminó esta bacteria en el 70% y 76%, respectivamente. Estos resultados revelan la alta frecuencia de lesiones preneoplásicas en nuestro medio asociadas a Helicobacter pylori y la excelente respuesta a tratamiento. Ofrecen también una posible alternativa para prevenir esta neoplasia frecuente en México.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990. lnt J Cancer 1999; 80:827-41.

2. Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. lnt J Cancer 1999;83:18-29.

3. Muñoz N, Franceschi S. Epidemiology of gastric cancer and perspectives for prevention. Salud Pública (Méx) 1997; 39:318-30.

4. De Stefani E, Boffetta P, Brennan P, Deneo-Pellegrini H, Carzoglio JC, Ronco A, Mendilaharsu M. Dietary carotenoids and risk of gastric cancer a case-control study in Uruguay. Eur J Cancer Prev 2000:329-34.

5. Botterweck AA, Van den Brandt PA, Goldbohm RA. Vitamins, carotenoids, dietary fiber, and the risk of gastric carcinoma: results from a prospective study after 6.3 years of follow-up. Cancer 2000; 88:737-48.

6. Parsonnet J, Hansen S, Rodríguez L. Helicobacter pylori infection and gastric carcinoma. N Engl J Med 1994;330: 1267-71.

7. Danesh J. Is Helicobacter pylori infection a cause of gastric neoplasia? Cancer Surveys 1999;33:263-89.

8. Correa P. Helicobacter pylori and gastric carcinogenesis. Am J Surg Pathol 1995;19:S37-S43.

9. Borody TJ, Andrews P, Mancuso N, Mccauley D, Jankiewicz E, Ferch N, Shortis NP, Barndl S. Helicobacter reinfection in patients with cured duodenal ulcer. Am J Gastroenterol 1004;89:529-32.

10. Parsonnet J, Hansen S, Rodríguez L, Gelb Ab, Wamke Ra, Jellum E, Orentreich N, Vogelman JH, Friedman GD. Helicobacter pylori infection and gastric lymphoma.

11. Forman D. Helicobacter pylori infection and cancer. British Med Bull 1998;54:71-8.

12. Parsonnet J, Fnedman GD, Vandersteen DP. Helicobacter pylori infection and the risk for gastric carcinoma. N Engl J Med 1991;325:1127-31.

13. Danesh J. Is Helicobacter pylori infection a cause of gastric neoplasia? Cancer Surveys 1999;33:263-89.

14. Kuipers EJ, Uyterlinde AM, Peña AS. Long-term sequel of Helicobacter pylori gastritis. Lancet 1995;345:1525-8.

15. Correa P, Haenszel W, Cuello C, Zavala D, Fontham E, Zarama G, Tannebaum S, Collazos T, Ruiz B. The gastric precancerous process in a high risk population: cohort follow-up. Cancer Res 1990;50:4737-40.

16. Halperin D, Mohar A. Stomach cancer duster in Mexico. Lancet 1988;1:1055.

17. Guarner J, Mohar A, Parsonnet J, Halperin D. The association of Helicobacter pylori with gastric cancer and preneoplastic gastric lesions in Chiapas, Mexico. Cancer 1993;71:297-301.

18. Linstedt G, Olbe L, Kilander AF, Armbrecht U, Jagenburg R, Runsteen D, Lundberg PA. Analytical and clinical evaluation of a radioimmunoassay for gastrin. Clin Chem 1985;31:76-82.

19. Dixon MF, Genta RM, Yardley JH, Correa P. And the Participants of the International Workshop on the Histopathology of Gastritis, Houston 1994: Classification and grading of gastritis: the updated Sydney system. Am J Surg Pathol 1996; 20:1161-1181.

20. Guarner J, Herrera-Goepfert R, Mohar A, Sánchez L, Halpeñn D, Ley C, Parsonnet J. Interobserver variability in application of the revised Sydney Classification for Gastritis. Human Pathology. 1999;30:1431-4.

21. Pounder RE, Ng D. The prevalence of Helicobacter pylori infection in different countries. Alimentary Pharmacol & Therapy 1995; 9(suppl 2) 533-539.

22. Parsonnet J. The incidence of Helicobacter pylori infection. Alimen Pharmacol Ther 1995;9 (Suppl 2)45-51.

23. The EUROGAST Study Group. Epidemiology of, and risk factors for, Helicobacter pylori infection among 3,149 asymptomatic subjects in 17 populations. Gut 1993; 34:1672-6.

24. Ley C, Mohar A, Guamer J, Herrera-Goepfert R, Sanchez-Figueroa L, Halperin D, Parsonnet J. Screening Markers for Chronic Atrophic Gastritis in Chiapas, Mexico. Cancer Epidemiol Biomark Prev 2001;9:1-6.

25. You WC, Blot WJ, Li JY, Chang YS, Jin ML, Kneller R. Zhang L, Han ZX, Zeng XR, Liu WD, Zhao L, Correa P, Fraumeni JF Jr, Xu GW. Precancerous gastric lesions in a population at high risk of stomach cancer. Cancer Res 1993;53:1317-21.

26. Correa P, Haenszel W, Cuello C, Zavala D, Fontham E, Zarama G. Tannebaum S, Collazos T, Ruiz B. The gastric precancerous process in a high risk population: cross-sectional studies. Cancer Res 1990;50:4731-6.

27. Muñoz N, Kato I Peraza A, López G, Carillo E, Ramírez H, Vivas J, Denis C, Sánchez V, Anadrade O, Buiatti E, Oliver W. Prevalence of precancerous lesions of the stomach in Venezuela. Cancer Epidemiol Biomed Prev 1996;5:41-6.

28. Blaser MJ, Chyous PH, Nomura A. Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer and duodenal ulcer risk. Cancer Res 1995;55:562-5.

29. López-Carrillo L, López-Cervantes M, Ward MH, Bravo-Alvarado J, Ramirez-Espitia A. Nutrient intake and gastric cancer in Mexico. Int J Cancer 1999;83:601-5.

30. Mohar A, Suchil L, Hernández A, Podolsky I, Herrera R, Mora T. Intestinal type: diffuse type ratio of gastric carcinoma in a Mexican population. J Ex Clin Cancer Res. 1997;16:1-6

31. López-Carrillo L, Hernández-Ávila M, Dubrow WR. Chili-pepper consumption and gastric cancer in Mexico. A case-control study. Amer J Epidemiol 1994;3:263-71.

32. Ramírez-Mayans J, Zamora-Dávila E, Cervantes-Bustamante R, Mata-Rivera N. Cyervides-García Cl, Cuevas-Schacht F, Sosa de Martínez MC. Eradication of H. pylori in patients with recurrent abdominal pain using a triple therapy drug treatment. Rev Gastroenterol Mex 1996;4:310-3.

33. López-Vida Y, Rangel-Frausto S, Calva JJ. Antibiotic resistance of Helicobacter pylori in an infectious disease referral center. Rev lnvest Clin 1998;50:19-24.

34. Correa P, Fontham ETH, Bravo JC, Bravo LE, Ruiz B, Zarama G, et al. Chemoprevention of gastric dysplasia: randomized trial of antioxidant supplements and ant- Hellcobacter pylori therapy. J Natl Cancer Inst 2000;92:1881-8.

35. Buiatti E, Muñoz N, Vivas J, Cano E, Peraza S, Carrillo E, Castro D, San chez V, Andrade O, Benz M, Sanjosé S, Oliver W. Difficulty in eradicating Helicobacter pylori in a population at high risk for stomach cancer in Venezuela. Cancer Causes Control 1994;5:249-54.

36. Ramírez-Ramos A, Gilman RH, León-Barua R, Recavarren-Arce S, Watanabe J, Salazar G, et al. Rapid recurrence of Helicobacter pylori infection in Peruvian patients after successful eradication. Gastrointestinal Physiology Working Group of the Universidad Peruana Cayetano Heredia and the Johns Hopkins University. Clin lnfect Dis 1997;25:1027-31.

37. Mitchell HM, Hu P, Chi Y, Chen MH, Li YY, Hazell SI. A low rate of reinfection following effective therapy against Helicobacter pylori in a developing nation (China) Gastroenterology 1998;114:256-61.

38. Sung JJY, Lin SR, Ching JL, Zhou LY, To KF, Wang RT, et al. Atrophy and intestinal metaplasia one year after cure of H. pylori infection: A prospective, randomized study. Gastroenterology 2000;119:7-14.

39. Forbes GM, Warren JR, Giaser ME, Cullen DJE, Marshall BJ, Collins BJ. Long term follow-up of gastric histology after H. pylori eradication. J Gastroenterol Hepatol 1996;11:670-3.

40. Parkin DM, Pisani P, Muñoz N, Ferlay J. The global health burden of infection associated cancers. Cancer Surveys 1999;33:5-33.