RESUMO
BACKGROUND AND METHODS: Upper endoscopy records from 1998 to 2003 were reviewed. The demographic data, endoscopic diagnosis, results of rapid urease test and the absence or presence of intestinal metaplasia (IM) in histology were reviewed, to evaluate the prevalence of IM and Helicobacter pylori (Hp) infection over time in Hong Kong. RESULTS: Among 1805 endoscopies performed, 1751 had both rapid urease test and histology available. A significant drop in the prevalence of duodenal ulcers from 17.9% in 1998 to 9.8% in 2003 was found (P = 0.015). Prevalence of IM was 13.9%, 5.9% and 9.4% in Hp positive, Hp negative and overall respectively (P < 0.05). The prevalence of IM increased with age, and the patterns were similar amongst subjects in 1998-2000 and those in 2001-2003. There was progressive decrease in Hp prevalence from 58% in 1998 to 40% in 2001 (P = 0.014), but no further decrease was seen in 2002-3. There was no corresponding decrease in IM prevalence. Instead IM prevalence in 2002-2003 was significantly higher than the prevalence in previous few years (P = 0.04). CONCLUSION: The prevalence of IM did not change in the period from 1998 to 2003 despite a drop in the prevalence of Hp infection since 1994.
Assuntos
Neoplasias Esofágicas/epidemiologia , Infecções por Helicobacter/epidemiologia , Helicobacter pylori/patogenicidade , Lesões Pré-Cancerosas/epidemiologia , Neoplasias Gástricas/epidemiologia , Úlcera Gástrica/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Testes Respiratórios , Úlcera Duodenal/epidemiologia , Úlcera Duodenal/microbiologia , Úlcera Duodenal/patologia , Endoscopia Gastrointestinal , Neoplasias Esofágicas/microbiologia , Neoplasias Esofágicas/patologia , Esofagoscopia , Feminino , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Hong Kong/epidemiologia , Humanos , Masculino , Metaplasia , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/microbiologia , Lesões Pré-Cancerosas/patologia , Prevalência , Distribuição por Sexo , Fatores Sexuais , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Úlcera Gástrica/microbiologia , Úlcera Gástrica/patologia , Fatores de Tempo , Adulto JovemRESUMO
Although various types of treatment of hepatocellular carcinoma (HCC) have been tried, the prognosis remains dismal, especially in patients with advanced stage of the disease. Somatostatin analogues exert antitumor effects. HCC have been shown to exhibit somatostatin receptors. The present randomized placebo-controlled study aimed at examining the efficacy of long-acting octreotide (Sandostatin LAR) for the treatment of advanced HCC. Seventy patients were randomized to receive a 2-week course of 250 microg short-acting octreotide twice daily followed by Sandostatin LAR 30 mg injection once every 4 weeks for 6 doses (n = 35) or placebo (control group) (n = 35). The clinical and laboratory parameters were monitored. There was no difference in the cumulative survival between the Sandostatin LAR-treated group compared with the control group [median survival 1.93 months vs. 1.97 months, respectively, P = NS (log-rank test)]. There was no tumor regression and no reduction of alpha-fetoprotein (AFP) levels in patients receiving Sandostatin LAR treatment. There was no improvement of quality of life assessed by Karnofsky performance score. In conclusion, Sandostatin LAR monotherapy did not have survival benefit in our selected group of patients with advanced HCC. Further studies should be performed in patients with less advanced disease and/or different etiology to evaluate its benefit.
