Assuntos
Hepatopatias/diagnóstico por imagem , Esplenose/diagnóstico por imagem , Idoso , Carcinoma Hepatocelular/diagnóstico , Diagnóstico Diferencial , Humanos , Hepatopatias/patologia , Neoplasias Hepáticas/diagnóstico , Imageamento por Ressonância Magnética/métodos , Masculino , Esplenectomia , Esplenose/patologiaAssuntos
Cisto do Colédoco/complicações , Cisto do Colédoco/diagnóstico por imagem , Pâncreas/anormalidades , Pâncreas/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Pancreatite/etiologia , Doença Aguda , Idoso , Colangiopancreatografia por Ressonância Magnética , Humanos , Masculino , Ductos Pancreáticos/diagnóstico por imagemAssuntos
Colo Descendente , Doenças do Colo/complicações , Doenças do Colo/patologia , Hemorragia Gastrointestinal/etiologia , Hematoma/complicações , Hematoma/patologia , Doenças do Colo/diagnóstico por imagem , Colonoscopia , Hematoma/diagnóstico por imagem , Hemofilia A/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XAssuntos
Fármacos Gastrointestinais/uso terapêutico , Imunossupressores/uso terapêutico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Tuberculose Latente/diagnóstico , Teste Tuberculínico/métodos , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: First-degree relatives (FDRs) of early-onset gastric carcinoma (EOGC) patients are at increased risk of cancer development. OLGA/OLGIM (Operative Link on Gastritis/Intestinal Metaplasia Assessment) classifications have been proposed for the identification of individuals at high risk of gastric cancer development. AIM: To estimate the prevalence and severity of premalignant conditions and lesions in FDRs of EOGC patients. METHODS: A case-control study was conducted encompassing 103 FDRs of EOGC patients (cases) and 101 age- and gender-matched controls, all submitted to upper GI endoscopy and OLGA and OLGIM used for staging as well as modified versions with exclusion of the biopsies from incisura angularis in the analysis. RESULTS: Helicobacter pylori infection was present in 82% of cases (P = 0.001). Atrophy was present in 70% of cases (OLGA stages I-IV). High-risk stages (III-IV) were identified only in cases (19%) (P < 0.001). Dysplasia was diagnosed only in cases (n = 7, P = 0.007). The application of OLGIM, modified OLGA and modified OLGIM classifications led to downgrade of stages in comparison with the original OLGA classification (27%, 15% and 30% respectively). In all classification systems, dysplastic lesions clustered (86%) in high-risk stages. CONCLUSIONS: FDRs of EOGC patients have, even at young ages, a high prevalence of H. pylori infection, high-risk OLGA and OLGIM stages and dysplasia. These patients should undergo accurate endoscopic observation with at least four biopsies in antrum and corpus to allow adequate staging and follow-up of premalignant conditions and lesions scored in high-risk stages, in accordance with international guidelines recently proposed.