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1.
J Gastrointest Cancer ; 54(2): 513-519, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35488975

RESUMEN

PURPOSE: Worldwide, gastric cancer (GC) is the 5th cancer with the highest incidence and the 4th in mortality. To reduce it, one strategy is to diagnose preneoplastic lesions (PNL): atrophic gastritis (AG), intestinal metaplasia (IM), and dysplasia (DYS); to form risk groups on which to focus surveillance efforts as are first-degree relatives (FDR). The aim of this study was to determine prevalence of gastric PNL in FDR of patients with GC, and to study association with sex, age, and Helicobacter pylorii (Hp) infection. METHODS: Cross-sectional study. One hundred and ten FDR, aged between 50 and 65 years, 54.5 female, obtained through convenience sampling, were studied. Biodemographic data survey and upper gastrointestinal endoscopy with histological study were applied according to Sidney protocol, and focal lesions found. Diagnosis of these lesions and condition of mucosa was carried out by applying OLGA and OLGIM systems. Descriptive statistics, estimation of prevalence, odds ratio (OR), and 95% confidence intervals (95CI) were calculated. RESULTS: Median age of study group was 56.5 years. Prevalence of PNL, AG, IM, and DYS were 86.4%, 82.7%, 54.5%, and 12.7% respectively. Advanced stages of OLGA and OLGIM were verified in 18.0% and 16.3% respectively. No association with sex, age, and Hp infection were found ([OR 3.10; 95CI 1.0; 9.64]; [OR 0.74; 95CI 0.26; 2.14]; [OR 0.58; 95CI 0.12; 2.77]) respectively. CONCLUSION: FDR of patients with GC have a high prevalence of PNL, which makes them a risk group in which endoscopic surveillance should be applied.


Asunto(s)
Gastritis Atrófica , Infecciones por Helicobacter , Helicobacter pylori , Lesiones Precancerosas , Neoplasias Gástricas , Humanos , Femenino , Persona de Mediana Edad , Anciano , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/genética , Neoplasias Gástricas/diagnóstico , Estudios Transversales , Prevalencia , Lesiones Precancerosas/epidemiología , Lesiones Precancerosas/patología , Gastritis Atrófica/epidemiología , Gastritis Atrófica/complicaciones , Gastritis Atrófica/diagnóstico , Factores de Riesgo , Hiperplasia/complicaciones , Metaplasia/epidemiología , Metaplasia/patología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/diagnóstico , Mucosa Gástrica/patología
2.
Gastroenterology ; 160(4): 1106-1117.e3, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33220252

RESUMEN

BACKGROUND & AIMS: Helicobacter pylori eradication and endoscopic surveillance of gastric precancerous lesions are strategies to reduce gastric cancer (GC) risk. To our knowledge, this study is the longest prospective cohort of an H pylori eradication trial in a Hispanic population. METHODS: A total of 800 adults with precancerous lesions were randomized to anti-H pylori treatment or placebo. Gastric biopsy samples taken at baseline and 3, 6, 12, 16, and 20 years were assessed by our Correa histopathology score. A generalized linear mixed model with a participant-level random intercept was used to estimate the effect of H pylori status on the score over time. Logistic regression models were used to estimate progression by baseline diagnosis and to estimate GC risk by intestinal metaplasia (IM) subtype and anatomic location. RESULTS: Overall, 356 individuals completed 20 years of follow-up. Anti-H pylori therapy (intention-to-treat) reduced progression of the Correa score (odds ratio [OR], 0.59; 95% confidence interval [CI], 0.38-0.93). H pylori-negative status had a beneficial effect on the score over time (P = .036). Among individuals with IM (including indefinite for dysplasia) at baseline, incidence rates per 100 person-years were 1.09 (95% CI, 0.85-1.33) for low-grade/high-grade dysplasia and 0.14 (95% CI, 0.06-0.22) for GC. Incomplete-type (vs complete-type) IM at baseline presented higher GC risk (OR, 13.4; 95% CI, 1.8-103.8). Individuals with corpus (vs antrum-restricted) IM showed an OR of 2.1 (95% CI, 0.7-6.6) for GC. CONCLUSIONS: In a high-GC-risk Hispanic population, anti-H pylori therapy had a long-term beneficial effect against histologic progression. Incomplete IM is a strong predictor of GC risk.


Asunto(s)
Antibacterianos/uso terapéutico , Mucosa Gástrica/patología , Infecciones por Helicobacter/tratamiento farmacológico , Lesiones Precancerosas/epidemiología , Neoplasias Gástricas/prevención & control , Adulto , Anciano , Biopsia , Colombia/epidemiología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Mucosa Gástrica/diagnóstico por imagen , Mucosa Gástrica/microbiología , Gastroscopía/estadística & datos numéricos , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Helicobacter pylori/aislamiento & purificación , Humanos , Incidencia , Masculino , Metaplasia/diagnóstico , Metaplasia/epidemiología , Metaplasia/microbiología , Metaplasia/patología , Persona de Mediana Edad , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/microbiología , Lesiones Precancerosas/patología , Estudios Prospectivos , Factores de Riesgo , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patología , Resultado del Tratamiento
3.
Pathol Res Pract ; 216(6): 152975, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32360248

RESUMEN

PURPOSE: Main study: undertake a histological study of odontogenic cysts (OC) to determine the prevalence of dystrophic calcification and metaplasia to respiratory epithelium on a Brazilian population. LITERATURE REVIEW: to review the literature for studies that investigated the prevalence of respiratory metaplasia and dystrophic calcification on OC. METHODS: Main study: a retrospective histopathological evaluation was made of the archives from a pathology laboratory. A total of 362 cases diagnosed as OC were identified; they were analyzed by two expert observers to determine the presence of dystrophic calcification and respiratory metaplasia. The association with sex, age and anatomic location was performed through statistical analysis. LITERATURE REVIEW: a critical literature review was undertaken. Two main electronic databases (PubMed and LILACS) were searched. Retrospective studies of histological evaluation that determined the prevalence of epithelial metaplasia and dystrophic calcification on OC, with at least 10 cases, were included; their findings were summarized and discussed. RESULTS: Main study: the histological evaluation of OC revealed the presence of respiratory epithelium in 25 cases (6.9%) and dystrophic calcification in 24 cases (6.6%). Positive association was found to dystrophic calcification on residual cyst and age; respiratory metaplasia on OC and sex; respiratory metaplasia on residual cyst and gnatic bone; respiratory metaplasia in OC and gnatic bone; dystrophic calcification in OC and anatomic site of mandible. LITERATURE REVIEW: eleven studies were included in the literature review, and respiratory metaplasia ranged from 0.0% to 19.2% while dystrophic calcification ranged from 2.5% to 40.5%. CONCLUSIONS: the histological evaluation of this study found 6.9% of prevalence of respiratory metaplasia and 6.6% of dystrophic calcification, which is in accordance with the literature reviewed. Therefore, these phenomena must be taken into account in routine diagnosis services.


Asunto(s)
Calcinosis/patología , Enfermedades Maxilomandibulares/patología , Metaplasia/patología , Quistes Odontogénicos/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil , Calcinosis/epidemiología , Niño , Preescolar , Femenino , Humanos , Masculino , Metaplasia/epidemiología , Persona de Mediana Edad , Prevalencia , Mucosa Respiratoria/patología , Estudios Retrospectivos , Adulto Joven
4.
Gastroenterol. latinoam ; 29(1): 9-15, 2018. tab, graf
Artículo en Español | LILACS | ID: biblio-1116687

RESUMEN

Background: Atrophic gastritis (AG) and intestinal metaplasia (IM) are stages that appear in the process of gastric carcinogenesis. Their presence requires programmed endoscopic vigilance. Objectives: To determine the frequency of AG and IM in gastric biopsies (GB) taken according to Sydney Protocol and to correlate them with endoscopic findings. Methods: Retrospective descriptive analysis of 233 upper gastrointestinal endoscopies with GB per Sydney Protocol. OLGA (Operative Link for Gastritis Assessment) and OLGIM (Operative Link for Gastric Intestinal Metaplasia Assessment) scores were calculated based on the GB description. Endoscopic findings were analyzed for atypical findings and compared to the GB report. Statistic analysis for Kappa and ANOVA was performed via Stata 12. Results: Mean age of patients was 58 ± 12 years. 69% were women. The frequency of AG and IM was 44% and 33% in the antrum, 31% and 20% in the angular incisure and 14% and 9% in the body, respectively. AG and IM were more frequent in the antrum (p < 0.05). AG and IM were more severe in the angular incisure and body (p < 0.05). We were unable to calculate OLGA and OLGIM in 6% and 9% of cases, respectively, due to absence of severity description in GB. 53% were OLGA 0, 42% OLGA I-II and 5% OLGA III-IV. 70% were OLGIM 0, 25% OLGIM I-II and 5% OLGIM III-IV. Agreement between endoscopic and histological findings was best for IM in the antrum (75.5%, Kappa 0.4). Sensitivity and specificity of endoscopic findings were 39% and 70% for AG, and 30% and 85% for IM, respectively. Conclusion: AG and IM are frequent findings in our patients. Due to the low endoscopic sensitivity for AG and IM, we suggest a systematic GB sampling using Sydney Protocol in patients over 40 years old.


Introducción: La gastritis crónica atrófica (GCA) y la metaplasia intestinal (MI) son etapas en el proceso de carcinogénesis gástrica, su presencia requiere control endoscópico programado. Objetivos: Determinar la frecuencia de GCA y MI en biopsias gástricas (BG) por protocolo de Sydney y relacionarlas con el hallazgo endoscópico. Métodos: Estudio descriptivo mediante revisión de 233 endoscopias digestivas altas con BG por Protocolo Sydney. Se graduó puntaje OLGA (Operative Link for Gastritis Assessment) y OLGIM (Operative Link for Gastric Intestinal Metaplasia Assessment) según la descripción de la BG. Se definió el hallazgo endoscópico según su informe y se comparó con BG como patrón de referencia. Estadística: Stata 12 para Kappa y ANOVA. Resultados: Edad promedio 58 ± 12 años, 69% mujeres. La frecuencia de GCA y MI en antro fue de 44 y 33%, en ángulo 31 y 20% y en cuerpo 14 y 9%, respectivamente. Hubo mayor frecuencia de GCA y MI en antro (p < 0,05). La graduación de GCA y MI fue mayor en ángulo y cuerpo (p < 0,05). No se obtuvo OLGA en 6% y OLGIM en 9% por ausencia de graduación. La frecuencia de OLGA 0 fue de 53%, OLGA I-II 42%, OLGA III-IV 5%, OLGIM O 70%, OLGIM I-II 25% y OLGIM III-IV 5%. La mejor correlación se observó entre la MI antral endoscópica con la histológica (75,5%, Kappa 0,4). La sensibilidad y especificidad endoscópica fue de 39 y 70% para GCA y 30 y 85% para MI. Conclusión: GCA y MI son hallazgos frecuentes en nuestros pacientes. Por la baja sensibilidad endoscópica en la identificación de GCA y MI sugerimos la toma sistemática de BG por protocolo de Sydney en pacientes mayores de 40 años.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/epidemiología , Gastritis Atrófica/diagnóstico , Gastritis Atrófica/epidemiología , Metaplasia/diagnóstico , Metaplasia/epidemiología , Lesiones Precancerosas/patología , Biopsia/métodos , Chile/epidemiología , Protocolos Clínicos , Tamizaje Masivo/métodos , Epidemiología Descriptiva , Prevalencia , Estudios Retrospectivos , Análisis de Varianza , Endoscopía Gastrointestinal , Sensibilidad y Especificidad , Mucosa Gástrica/patología , Gastritis Atrófica/patología , Metaplasia/patología
5.
Gastrointest Endosc ; 84(1): 18-28, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-26940296

RESUMEN

BACKGROUND AND AIMS: Although the incidence of gastric cancer in the United States is relatively low, the incidence of gastric cancer is higher than for esophageal cancer, for which clear guidelines for screening and surveillance exist. With the increasing availability of endoscopic therapy, such as endoscopic submucosal dissection, for treating advanced dysplasia and early gastric cancer, establishing guidelines for screening and surveillance of patients who are at high risk of developing gastric cancer has the potential to diagnose and treat gastric cancer at an earlier stage and improve mortality from gastric cancer. The aims of this article were to review the data regarding the risk factors for developing gastric cancer, methods for gastric cancer screening, and results of national screening programs. METHODS: A review of the existing literature related to the aims was performed. RESULTS: Risk factors for gastric cancer that were identified include race/ethnicity (East Asian, Russian, or South American), first-degree relative diagnosed with gastric cancer, positive Helicobacter pylori status, and presence of atrophic gastritis or intestinal metaplasia. Endoscopy has the highest rate of detecting gastric cancer compared with other gastric cancer screening methods. The national screening program in Japan has demonstrated a mortality reduction from gastric cancer based on cohort data. CONCLUSIONS: Gastric cancer screening with endoscopy should be considered in individuals who are immigrants from regions associated with a high risk of gastric cancer (East Asia, Russia, or South America) or who have a family history of gastric cancer. Those with findings of atrophic gastritis or intestinal metaplasia on screening endoscopy should undergo surveillance endoscopy every 1 to 2 years. Large prospective multicenter studies are needed to further identify additional risk factors for developing gastric cancer and to assess whether gastric cancer screening programs for high-risk populations in the United States would result in improved mortality.


Asunto(s)
Detección Precoz del Cáncer/métodos , Gastroscopía/métodos , Neoplasias Gástricas/diagnóstico , Asiático , Etnicidad , Asia Oriental/etnología , Gastritis Atrófica/epidemiología , Infecciones por Helicobacter/epidemiología , Helicobacter pylori , Hispánicos o Latinos , Humanos , Incidencia , Metaplasia/epidemiología , Federación de Rusia/etnología , América del Sur/etnología , Estómago/patología , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etnología , Estados Unidos/epidemiología
6.
Zoo Biol ; 33(6): 516-26, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25255888

RESUMEN

The success of ex situ survival assurance populations as tools for amphibian conservation depends on the health and reproductive success of founder populations. Necropsy examination and histopathology of animals that die in assurance populations are useful for the identification of population-limiting disease problems and can help to direct applied research efforts in areas such as amphibian husbandry and nutrition. This study reviewed postmortem findings in 167 frogs from 13 species that died in a large Panamanian rescue and survival assurance population between 2006 and 2011. Common problems identified in long-term captive animals, especially in Atelopus species, were epithelial squamous metaplasia suggestive of vitamin A deficiency and a polycystic nephropathy resembling lesions seen in laboratory animals with electrolyte imbalances. Metabolic bone disease was a significant contributor to morbidity in captive-bred juvenile frogs of Gastrotheca cornuta, Hemiphractus fasciatus, and Hylomantis lemur. Findings common to multiple species included poor overall nutritional condition that was sometimes attributable to maladaptation to captive husbandry and epidermal hyperplasia and hyperkeratosis possibly reflecting environmental skin irritation. Infectious diseases and endoparasitism were most common in recently captured animals and included chytridiomycosis and Rhabdias sp. lungworms. Applied research efforts to improve sustainability of survival assurance populations should focus on elucidating optimal husbandry practices for diverse species, improving methods for nutritional supplementation of cultured insects and examination of the role of water composition in disease development.


Asunto(s)
Animales de Zoológico , Anuros , Enfermedades Óseas Metabólicas/veterinaria , Conservación de los Recursos Naturales/métodos , Metaplasia/veterinaria , Mortalidad , Enfermedades Renales Poliquísticas/veterinaria , Fenómenos Fisiológicos Nutricionales de los Animales/fisiología , Animales , Enfermedades Óseas Metabólicas/epidemiología , Enfermedades Óseas Metabólicas/patología , Conservación de los Recursos Naturales/estadística & datos numéricos , Metaplasia/epidemiología , Metaplasia/patología , Panamá/epidemiología , Enfermedades Renales Poliquísticas/epidemiología , Enfermedades Renales Poliquísticas/patología , Especificidad de la Especie
7.
Cir Cir ; 78(4): 315-21, 2010.
Artículo en Español | MEDLINE | ID: mdl-21167097

RESUMEN

BACKGROUND: Esophageal metaplasia progression is a consequence of chronic gastroesophageal reflux (CGR). Patients with this condition are frequently infected by Helicobacter pylori and show several symptoms including gastritis as well as ulcer formation. In addition, they present an increased risk for the development of gastric adenocarcinoma. Several pathogenic markers for Helicobacter pylori such as ureC, vacA and cagA genes have been described. Evidence indicates that direct injury to the epithelial mucosa is caused by cytotoxins and enzymes codified by these genes. We undertook this study to establish a relationship between the presence of pathogenic Helicobacter pylori strains and the presence of metaplasia progression in patients with CGR. METHODS: We detected the presence of Helicobacter pylori cagA and vacA positive strains in patients with CGR. Using polymerase chain reaction, we analyzed 120 samples obtained from 60 patients with CGR and 60 control group patients, including samples from both anatomic areas: cardia and gastric antrum. RESULTS: We detected 56% of Helicobacter pylori positive patients; 57.5% of these patients were positive for either cagA(+) and/or vacA(+) Helicobacter pylori strains. Cardiac intestinal metaplasia was observed in 35% of the patients. A marked tendency was observed to develop cardiac intestinal metaplasia in those patients diagnosed with high-pathogenicity strains infected in both anatomic areas. CONCLUSIONS: These results suggest that infection with Helicobacter pylori can be considered a risk factor for developing gastric cardiac intestinal metaplasia.


Asunto(s)
Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Esófago de Barrett/epidemiología , Cardias/patología , Gastritis Atrófica/patología , Infecciones por Helicobacter/patología , Helicobacter pylori/patogenicidad , Adulto , Anciano , Esófago de Barrett/etiología , Esófago de Barrett/microbiología , Esófago de Barrett/patología , Biopsia , Estudios Transversales , Femenino , Gastritis Atrófica/complicaciones , Gastritis Atrófica/microbiología , Reflujo Gastroesofágico/complicaciones , Gastroscopía , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Helicobacter pylori/aislamiento & purificación , Humanos , Masculino , Metaplasia/epidemiología , Metaplasia/etiología , Persona de Mediana Edad , Neutrófilos/patología , Lesiones Precancerosas/epidemiología , Lesiones Precancerosas/etiología , Lesiones Precancerosas/microbiología , Lesiones Precancerosas/patología , Estudios Prospectivos , Especificidad de la Especie , Virulencia , Adulto Joven
8.
Int J Cancer ; 123(2): 414-420, 2008 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-18449884

RESUMEN

Most cases of gastric cancers occur in non-industrialized countries but there is scarce information about the epidemiology of this illness in these countries. Our study examined whether there was a variation in the prevalence of gastric cancer in Lima, Perú over the last 2 decades. Subjects older than 29 years of age were included. They underwent an esophagogastroduedonoscopy at 3 socioeconomically different health facilities in Lima: a county hospital (7,168 subjects), a Peruvian-Japanese Clinic (14,794 individuals) and a private hospital (4,893 individuals). Birth cohort prevalence of gastric cancer was used. Regression models were calculated to predict the future prevalence of gastric cancer. It was found that the birth cohort prevalence of gastric cancer decreased in Perú from 22.7 to 2% (p < 0.001), from 12 to 0.5% (p < 0.001), and from 6.5 to 0.1% (p < 0.001) in the low, middle and high socioeconomic group, respectively. The prevalence of intestinal metaplasia decreased from 44.3 to 12.5% (p < 0.001), from 28.4 to 5% (p < 0.001), and from 19.4 to 2.2% (p < 0.001) in the low, middle and high socioeconomic status, respectively. These trends will likely persist over the future decades. Nevertheless, the prevalence of gastric cancer remains high in subjects older than 59 years of age in the low socioeconomic status. It is concluded that the prevalence of gastric cancer is decreasing in Perú, similar to the current trend undergoing in industrialized nations. However, there are still specific groups with high prevalence that might benefit from screening for early detection and treatment.


Asunto(s)
Neoplasias Gástricas/epidemiología , Adulto , Distribución por Edad , Anciano , Factores de Confusión Epidemiológicos , Femenino , Humanos , Incidencia , Intestinos/patología , Masculino , Metaplasia/epidemiología , Persona de Mediana Edad , Perú/epidemiología , Pobreza , Prevalencia , Análisis de Regresión , Proyectos de Investigación , Estudios Retrospectivos , Factores de Riesgo , Distribución por Sexo , Clase Social , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/etiología
9.
Arq. gastroenterol ; Arq. gastroenterol;40(4): 220-226, out.-dez. 2003. tab
Artículo en Portugués | LILACS | ID: lil-359882

RESUMEN

RACIONAL: A metaplasia intestinal especializada pode ser classificada, de acordo com os achados endoscópicos e histológicos, em Barrett longo, Barrett curto e metaplasia intestinal da cárdia. O esôfago de Barrett é doença adquirida que ocorre em aproximadamente 10 por cento a 13 por cento dos indivíduos com doença do refluxo gastroesofágico e representa uma condição pré-neoplásica. É caracterizado por substituição do epitélio escamoso estratificado pelo metaplásico colunar especializado, contendo células caliciformes. OBJETIVOS: Determinar, prospectivamente, a prevalência e as características clínico-epidemiológicas da metaplasia intestinal especializada de esôfago distal na doença do refluxo gastroesofágico. MÉTODOS: Entre abril e outubro de 2002, 402 pacientes com sintomas da doença do refluxo gastroesofágico foram avaliados através de questionário padronizado que abordava as variáveis demográficas e foram submetidos a exame endoscópico com biopsias 1 cm abaixo da junção escamocolunar, nos quatro quadrantes. RESULTADOS: Metaplasia intestinal especializada foi encontrada em 18,4 por cento dos pacientes: 0,5 por cento Barrett longo, 3,2 por cento Barrett curto e 14,7 por cento metaplasia intestinal da cárdia. Houve tendência de maior número de homens apresentando esôfago de Barrett e mulheres com metaplasia intestinal da cárdia. Todos com esôfago de Barrett eram da raça branca. Não houve relação entre a intensidade dos sintomas da doença do refluxo gastroesofágico e a presença de metaplasia intestinal especializada. O tempo de duração de sintomas superior a 5 anos foi uma tendência nos portadores de esôfago de Barrett. Este grupo também apresentou mais hérnia de hiato e esofagite mais intensa do que aqueles com metaplasia intestinal da cárdia. Não houve relação entre uso de tabaco ou álcool e metaplasia intestinal especializada. CONCLUSÕES: Esôfago de Barrett foi mais relacionado ao sexo masculino, com sintomas de longa cronicidade, esofagite mais intensa e sem associação com tabaco ou álcool.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Persona de Mediana Edad , Esófago de Barrett/epidemiología , Reflujo Gastroesofágico/fisiopatología , Enfermedades Intestinales/epidemiología , Brasil/epidemiología , Cardias/patología , Metaplasia/epidemiología , Prevalencia , Estudios Prospectivos , Gastropatías/epidemiología
10.
Arq Gastroenterol ; 40(4): 220-6, 2003.
Artículo en Portugués | MEDLINE | ID: mdl-15264043

RESUMEN

BACKGROUND: Specialized intestinal metaplasia can be categorized according endoscopic and histological findings in long segment Barrett, short segment Barrett and specialized intestinal metaplasia of cardia. Barrett's esophagus is an acquired disease that is found in about 10%-13% of patients undergoing endoscopy for symptoms of gastroesophageal reflux disease and it is well established as predisposing to esophageal adenocarcinoma. The columnar epithelium with goblet cells replaces the normal squamous epithelium. OBJECTIVE: To determine the prevalence and clinical-demographic characteristics of specialized intestinal metaplasia of distal esophagus in the gastroesophageal reflux disease. METHODS: From April to October 2002, 402 patients referred to upper endoscopy due gastroesophageal reflux disease were evaluated through of a symptom questionnaire about clinical and demographic features and submitted to upper endoscopy with four-quadrant biopsies 1 cm below escamocolumnar junction. RESULTS: Eighteen point four percent of patients had specialized intestinal metaplasia, 0.5% long segment Barrett esophagus, 3.2% short segment Barrett's esophagus and 14.7% specialized intestinal metaplasia of cardia. Patients with Barrett's esophagus showed a tendency to be male and specialized metaplasia of cardia to be female. All patients with Barrett's esophagus were white. There was not association between symptoms of gastroesophageal reflux disease and specialized intestinal metaplasia, but patients with Barrett's esophagus showed a tendency to have symptoms over 5 years and had more hiatal hernia and esophagitis. The use of alcohol and tobacco was not related to the presence of specialized intestinal metaplasia. CONCLUSIONS: Barrett's esophagus was more related to the male gender, gastroesophageal reflux disease symptoms for 5 years or longer, more intense esophagitis and hiatal hernia, but was not related to the use of tobacco and alcohol.


Asunto(s)
Esófago de Barrett/epidemiología , Reflujo Gastroesofágico/fisiopatología , Enfermedades Intestinales/epidemiología , Adolescente , Anciano , Anciano de 80 o más Años , Esófago de Barrett/patología , Brasil/epidemiología , Cardias/patología , Femenino , Humanos , Enfermedades Intestinales/patología , Masculino , Metaplasia/epidemiología , Persona de Mediana Edad , Prevalencia , Estudios Prospectivos , Gastropatías/epidemiología , Gastropatías/patología
11.
Am J Gastroenterol ; 96(6): 1746-50, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11419824

RESUMEN

OBJECTIVE: Gastritis, intestinal metaplasia, atrophy, and dysplasia are disorders that frequently precede the full development of gastric adenocarcinoma. On the other hand, primary gastric lymphomas seem to arise from mucosa-associated lymphoid tissue. It is well accepted that these histological changes are caused by Helicobacter pylori infection. The objective of this study is to determine the frequency and characteristics of epithelial and lymphoid tissue disorders of the gastric mucosa surrounding primary carcinomas and lymphomas. METHODS: We studied 111 gastrectomies from patients harboring primary adenocarcinomas (30 intestinal and 30 diffuse type) and 51 gastric lymphomas. For comparative purposes, we analized 86 stomachs from patients who died of diseases other than gastric malignancies. Histopathological disorders of the gastric mucosa adjacent to primary neoplasms such as atrophy, intestinal metaplasia, and dysplasia were recorded. Lymphoid follicles were classified in two groups, with or without expansion. Expansion was characterized by increased size, irregular borders, enlarged marginal zone, and expanded germinal centers. Differences were statistically evaluated with chi2 and Fisher exact tests, odds ratio, and relative risk, with 95% CI. p values <0.05 were considered statistically significant. RESULTS: Most intestinal-type adenocarcinomas showed atrophy (76.6%) and intestinal metaplasia (86.6%) and less frequently, dysplasia (23.3%), in the surrounding gastric mucosa. Expansive lymphoid follicles were more frequent among lymphomas than in adenocarcinomas (56.8% vs 25%); however, a high percentage of lymphomas were also associated with atrophy (50.9%), intestinal metaplasia (62.7%), and rarely dysplasia (11.8%). On the contrary, diffuse-type adenocarcinoma displayed less frequently atrophy (33%), intestinal metaplasia (50%), and dysplasia (3%). Gastric mucosa from patients without any gastric neoplasia was almost normal (84%), whereas the remaining 16% showed, both or alone, atrophy and intestinal metaplasia. CONCLUSION: Histopathological disorders of the gastric mucosa are not specific for any neoplasm, but intestinal-type adenocarcinomas frequently showed atrophy, intestinal metaplasia, and not uncommonly, dysplasia of the surrounding non-neoplastic gastric mucosa. Diffuse-type adenocarcinomas did not frequently show such lesions. Primary lymphomas displayed expansive lymphoid follicles and also a high percentage of atrophy and intestinal metaplasia of the surrounding gastric mucosa. The presence of intestinal metaplasia, atrophy, and lymphoid follicles with expansion in endoscopic biopsies could suggest a higher suceptibility for the development of gastric intestinal-type adenocarcinoma or gastric lymphoma. Patients harboring such histopathological changes must receive eradication therapy against H. pylori and probably closer follow-up.


Asunto(s)
Adenocarcinoma/patología , Mucosa Gástrica/patología , Neoplasias Intestinales/patología , Linfoma/patología , Lesiones Precancerosas/patología , Neoplasias Gástricas/patología , Adenocarcinoma/microbiología , Adolescente , Adulto , Anciano , Femenino , Gastritis/epidemiología , Gastritis/patología , Gastritis Atrófica/epidemiología , Gastritis Atrófica/patología , Centro Germinal/patología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/patología , Helicobacter pylori , Humanos , Neoplasias Intestinales/microbiología , Linfoma/microbiología , Masculino , Metaplasia/epidemiología , Metaplasia/patología , Persona de Mediana Edad , Lesiones Precancerosas/epidemiología , Neoplasias Gástricas/microbiología
12.
Am J Gastroenterol ; 96(3): 666-72, 2001 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-11280531

RESUMEN

OBJECTIVE: A strong correlation exists between atrophic gastritis and the intestinal type of gastric carcinoma. Duodenal ulcer disease characteristically has an antral predominant gastritis and a lower risk for gastric cancer. The aim of this study was to investigate the extent and distribution of intestinal metaplasia in duodenal ulcer in countries differing in gastric cancer incidence. METHODS: Topographically mapped gastric biopsy specimens (median 11) were obtained from patients with duodenal ulcer in four countries (Korea, Colombia, USA, and South Africa). Sections were stained with a triple stain and evaluated for Helicobacter pylori (H. pylori), active inflammation, and intestinal metaplasia. RESULTS: One hundred and sixty-five patients with duodenal ulcer were examined (29 from Korea, 52 from Colombia, 62 from the USA, and 22 from South Africa). The percentage of biopsies with intestinal metaplasia was significantly greater in Korean patients (86%) compared with that in other countries (50%) (p = 0.0004). Intestinal metaplasia was most prevalent in the antrum lesser curve and greater curve, and the body lesser curve. Intestinal metaplasia was present in the gastric corpus of 38% of duodenal ulcer patients from Korea compared with an average of 10% elsewhere (p = 0.018). No differences were observed in the density or distribution of H. pylori infection or in the degree of active gastritis between countries. CONCLUSIONS: Although antral predominant gastritis is the prevalent pattern of gastritis in duodenal ulcer, intestinal metaplasia in the gastric corpus may be found with geographic differences. These findings suggest that duodenal ulcer and gastric cancer are not mutually exclusive diseases but are rather ends of the spectrum of H. pylori infection.


Asunto(s)
Úlcera Duodenal/patología , Intestinos/patología , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento/fisiología , Colombia , Úlcera Duodenal/microbiología , Femenino , Gastritis/microbiología , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/aislamiento & purificación , Humanos , Corea (Geográfico) , Masculino , Metaplasia/epidemiología , Persona de Mediana Edad , Prevalencia , Sudáfrica , Estados Unidos
13.
Rev. colomb. obstet. ginecol ; 48(3): 199-201, jul.-sept. 1997. tab
Artículo en Español | LILACS | ID: lil-293430

RESUMEN

Se presenta un caso raro de metaplasia ósea endometrial en una paciente de 22 años de edad, quien consultó por amenorrea secundaria de tres años de evolución posterior a un legrado realizado por aborto incompleto. Se realizó histeroscopia operatoria, dilatación y curetaje extrayendo fragmentos óseos cuyo estudio anatomopatológico confirma el diagnóstico de metaplasia ósea endometrial. Se hace discusión del tema y se exponen las diferentes teorías sobre su patogénesis


Asunto(s)
Humanos , Femenino , Metaplasia/diagnóstico , Metaplasia/epidemiología , Metaplasia/fisiopatología
14.
Rev. méd. Chile ; 124(5): 545-52, mayo 1996. ilus, tab
Artículo en Español | LILACS | ID: lil-174772

RESUMEN

Three gastric mucosal biopsies were obtained from 300 patients showing a normal upper digestive tract endoscopy. Histologically in 9 percent of the patients the biopsies were normal; in 87 percent showed a common-type chronic gastritis and in 4 percent showed a reactive (chemical or reflux-type) gastritis. Helicobacter pylori was present in 25.9 percent of the patients without gastritis, in 33.3 percent of the patients with reactive gastritis and in 87.7 percent of those with common-type gastritis. In 19.9 percent of the patients with common-type chronic gastritis there was intestinal metaplasia, consisting of type I metaplasia in 14.1 percent, type II in 3.1 percent and type III metaplasia in 2.3 percent. The association of type III intestinal metaplasia with the other forms of metaplasia, its lower frequency and its tendency to be present in older patients supports the hipothesis that type III incomplete colonic metaplasia represents a more advanced stage than complete and incomplete small bowel metaplasia of the gastric mucosa


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Gastroscopía , Gastritis/patología , Biopsia , Helicobacter pylori/aislamiento & purificación , Infecciones por Helicobacter/epidemiología , Metaplasia/etiología , Metaplasia/epidemiología , Distribución por Edad , Distribución por Sexo , Enfermedad Crónica/epidemiología
15.
J Clin Gastroenterol ; 15(4): 296-301, 1992 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-1294634

RESUMEN

We compared the prevalence of gastric metaplasia of the duodenal mucosa (GM) and its characteristics in 204 Peruvian patients from a low socioeconomic level with the corresponding prevalence reported in dyspeptic patients from a developed country, the United Kingdom. Gastric metaplasia was significantly less prevalent in the Peruvian than in the United Kingdom series. However, when present, GM was not significantly different in extent or frequency of colonization by Helicobacter pylori or association with active duodenitis, despite a higher prevalence of H. pylori-associated gastritis. Hypochlorhydria was markedly more frequent in the Peruvian than in the United Kingdom series. The finding of a low prevalence of H. pylori-colonized GM in patients with previously reported low prevalence of duodenal ulcer gives further support to a pathogenic link between both conditions.


Asunto(s)
Dispepsia/epidemiología , Dispepsia/patología , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/patología , Helicobacter pylori/aislamiento & purificación , Mucosa Intestinal/patología , Estómago/patología , Adolescente , Adulto , Anciano , Duodeno , Dispepsia/microbiología , Femenino , Infecciones por Helicobacter/microbiología , Humanos , Mucosa Intestinal/microbiología , Masculino , Metaplasia/epidemiología , Metaplasia/microbiología , Metaplasia/patología , Persona de Mediana Edad , Perú/epidemiología , Prevalencia , Factores Socioeconómicos , Estómago/microbiología , Reino Unido/epidemiología
17.
G E N ; 46(4): 311-6, 1992.
Artículo en Español | MEDLINE | ID: mdl-1340837

RESUMEN

Intestinal metaplasia has been shown by many investigators to be a premalignant state. Considering this fact, 722 gastric biopsies were studied, a 24% of association was found between gastric carcinoma and intestinal metaplasia and 27% of the cases with metaplasia were found in "apparently normal" or with benign stomach lesions. The group most affected was males over 61 years. Control endoscopy and biopsy was practiced in 17 patients with previously diagnosed intestinal metaplasia and in 11.7% gastric carcinoma with metaplasia was found. Therefore, it cannot be concluded that intestinal metaplasia is a premalignant condition, but its frequent association with gastric adenocarcinoma advises periodical examination by endoscopy in every patient over 40 years in which it is determined by biopsy.


Asunto(s)
Adenocarcinoma/patología , Intestinos/patología , Neoplasias Gástricas/patología , Adenocarcinoma/epidemiología , Adulto , Factores de Edad , Biopsia/estadística & datos numéricos , Femenino , Humanos , Masculino , Metaplasia/epidemiología , Metaplasia/patología , Persona de Mediana Edad , Estudios Prospectivos , Estudios Retrospectivos , Factores Sexuales , Estómago/patología , Neoplasias Gástricas/epidemiología , Venezuela/epidemiología
18.
Jpn J Cancer Res ; 83(5): 491-4, 1992 May.
Artículo en Inglés | MEDLINE | ID: mdl-1618699

RESUMEN

A systematic analysis of the cellular and structural components of intestinal metaplasia (IM) was carried out in 691 consecutive endoscopic gastric biopsies from Mexicans patients. Two-thirds of the patients (461 or 66.7%) had chronic gastritis, 27.6% (or 191 patients) had gastric ulcers and 5.6% (39 patients) gastric carcinomas. IM was found in 17.4% of the gastric biopsies. While IM was present in 27.7% of patients with gastric peptic ulcer, patients with gastric malignancy had only 18.7%, and the lowest rate (13.4%) was found in 461 biopsies from patients with chronic gastritis. IM was influenced by the age but not by the sex of the patients. Only one of 120 biopsies with IM (0.8%) had incomplete IM (a lesion claimed to be a precursor of gastric carcinoma). In a previous study it was found that 32.3% of 359 Swedish patients and 59.2% of 625 Japanese patients with chronic gastritis had IM, the proportion of incomplete IM being 23.3% and 25.1%, respectively. The low frequency of IM among Mexicans (a population with a low incidence of gastric carcinoma), contrasts with the moderate frequency of IM among Swedes (who have a moderate gastric cancer incidence) and with the high frequency of IM among Japanese (with a high incidence of gastric carcinoma). These findings recorded in disparate geographical regions strongly support the view that IM is a lesion evoked by environmental factors and associated with gastric carcinogenesis.


Asunto(s)
Mucosa Intestinal/patología , Estómago/patología , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Femenino , Gastritis/epidemiología , Gastritis/patología , Humanos , Japón/epidemiología , Masculino , Metaplasia/epidemiología , México/epidemiología , Persona de Mediana Edad , Factores Sexuales , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/patología , Úlcera Gástrica/epidemiología , Úlcera Gástrica/patología , Suecia/epidemiología
19.
Rev Med Chil ; 118(10): 1099-104, 1990 Oct.
Artículo en Español | MEDLINE | ID: mdl-2152626

RESUMEN

Epithelial alterations in pancreatic ducts may have a premalignant nature. We compared the incidence of different lesions in 49 pancreatic cancer specimens compared to 100 controls. Simple hyperplasia, mucosecretory metaplasia and pyloric metaplasia were evenly distributed among groups. In contrast, papillary hyperplasia, intestinal metaplasia and dysplasia were significantly more frequent in pancreas with carcinoma. Therefore, these lesions may have a precancerous nature.


Asunto(s)
Adenocarcinoma/patología , Conductos Pancreáticos/patología , Neoplasias Pancreáticas/patología , Lesiones Precancerosas/patología , Adenocarcinoma/epidemiología , Chile/epidemiología , Epitelio/patología , Femenino , Humanos , Hiperplasia/epidemiología , Hiperplasia/patología , Incidencia , Masculino , Metaplasia/epidemiología , Metaplasia/patología , Persona de Mediana Edad , Neoplasias Pancreáticas/epidemiología , Lesiones Precancerosas/epidemiología , Factores Sexuales
20.
Pathol Res Pract ; 178(6): 538-42, 1984 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-6483680

RESUMEN

The frequency and characteristics of intestinal metaplasia of the stomach were studied in autopsy material of 68 Chilean adults, with ages ranging from 30 to 79 years. Metaplasia was found in 76.5% of the cases, which is in agreement with the high frequency of metaplasia reported from other geographic areas of high incidence for gastric cancer. Of those stomachs with metaplasia, 90.4% had involvement of the lesser curvature, 88.5% of the antral region, and only 3.8% did not show the condition in those two areas. The metaplasia extended to less than half of the length of the mucosa in 85.6% of the sections with this change, showing that it is mainly a patchy and multifocal condition. In subjects older than 50 years, intestinal metaplasia was more extended and severe, and involved with a relative higher frequency the greater curvature and both anterior and posterior walls of the stomach.


Asunto(s)
Mucosa Gástrica/patología , Lesiones Precancerosas/epidemiología , Neoplasias Gástricas/epidemiología , Adulto , Factores de Edad , Anciano , Autopsia , Chile , Femenino , Humanos , Masculino , Metaplasia/epidemiología , Metaplasia/patología , Persona de Mediana Edad , Lesiones Precancerosas/patología , Estudios Prospectivos , Neoplasias Gástricas/patología
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