RESUMO
OBJECTIVE: Although Helicobacter pylori (H. pylori) eradication has been shown to inhibit gastric cancer, it does not completely suppress it. Therefore, risk factors of gastric cancer development following H. pylori eradication were examined. MATERIAL AND METHODS: A total of 2355 patients (1501 males and 824 females) underwent successful eradication of H. pylori. Endoscopic atrophy, histological gastritis, atrophy, intestinal metaplasia (IM), and operative link for gastritis assessment (OLGA) staging were subsequently evaluated. RESULTS: Following eradication, 33/2355 patients (25 males and 8 females) developed gastric cancer. Compared to a nongastric cancer group that was matched according to gender and age, the incidence of endoscopic atrophy (3.52 ± 1.45 vs. 4.85 ± 1.18, p < 0.001), histological atrophy at the greater curvature of the antrum (1.42 ± 0.80 vs. 1.95 ± 0.86, p = 0.0059), inflammation (2.05 ± 0.59 vs. 2.33 ± 0.66, p = 0.031), IM at the greater curvature of the corpus (0.06 ± 0.30 vs. 0.24 ± 0.54, p = 0.029), the ratio of OLGA-stage 0-II/III, IV (13/8 vs. 55/11, p = 0.038) were significantly higher for the gastric cancer group. Multivariate analysis also showed the highest odds ratio (6.26, 95% confidence interval or CI, 1.28-30.60, p = 0.023) for IM at the greater curvature of the corpus. CONCLUSIONS: Severe endoscopical atrophy, OLGA staging, histological atrophy at the antrum, inflammation, and particularly IM at the corpus, were identified as risk factors for gastric cancer development following H. pylori eradication. Therefore, eradication should be performed before these predictors develop.
Assuntos
Mucosa Gástrica/patologia , Infecções por Helicobacter/patologia , Infecções por Helicobacter/terapia , Helicobacter pylori , Neoplasias Gástricas/microbiologia , Neoplasias Gástricas/patologia , Idoso , Antibacterianos/uso terapêutico , Atrofia/microbiologia , Atrofia/patologia , Estudos de Coortes , Feminino , Mucosa Gástrica/microbiologia , Gastrite/microbiologia , Gastrite/patologia , Gastrite/terapia , Gastroscopia , Humanos , Masculino , Metaplasia/microbiologia , Metaplasia/patologia , Pessoa de Meia-Idade , Inibidores da Bomba de Prótons/uso terapêutico , Fatores de RiscoAssuntos
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Neoplasias do Ducto Colédoco/terapia , Duodenoscópios , Duodeno/lesões , Duodeno/cirurgia , Perfuração Intestinal/cirurgia , Icterícia Obstrutiva/terapia , Stents , Instrumentos Cirúrgicos , Técnicas de Sutura/instrumentação , Suturas , Idoso de 80 Anos ou mais , Humanos , Masculino , Cuidados Paliativos , RecidivaRESUMO
A 52-year-old woman was diagnosed with cap polyposis (CP) with characteristic clinical, endoscopic, and histological features. By avoiding straining at defecation, her symptoms improved temporarily, however recrudesced. She was diagnosed with Helicobacter pylori (H. pylori) infection, and received eradication therapy successfully. After this eradication therapy, her symptoms and colonoscopic findings recovered completely. Only two reports in the English language literature have discussed the relationship between CP and eradication therapy for H. pylori, all patients achieved complete recovery. We recommend H. pylori testing for all cases of CP and H. pylori eradication therapy if necessary.