Atrofia, metaplasia y cáncer gástrico: ¿dónde está la evidencia?
Palabras clave:
cáncer de estómago, cáncer gástrico, atrofia, metaplasia, medicina basada en evidenciaResumen
El cirujano que atiende pacientes con sintomatología gástrica debe tener un conocimiento profundo de los diferentes aspectos que puede reportar una endoscopia digestiva superior, entre ellos la presencia de atrofia y de metaplasia intestinal gástrica. Lo anterior es más importante todavía si se tiene en cuenta que Colombia es un país de alta prevalencia de cáncer gástrico.
Se hizo una revisión de la literatura sobre el proceso de atrofia, metaplasia y cáncer gástrico, tratando de buscar la mejor evidencia disponible que soporta la ocurrencia de esta secuencia de eventos, evaluando el papel del Helicobacter pylori y tratando de encontrar cómo debe ser el seguimiento de estos pacientes, con el objetivo de hacer un diagnóstico temprano del cáncer gástrico y finalmente dar unas recomendaciones de manejo.
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Referencias bibliográficas
1. Dicken B, Bigam D, Cass C, Mackey J, Joy A, Hamilton S. Gastric adenocarcinoma, review and considerations for future directions. Ann Surg 2005; 241: 27.
2. Graham D, Shiotani A. The time to eradicate gastric cancer is now. Gut 2005; 54: 735.
3. Doglietto G, Pacelli F, Caprino P, Sgadari A, Crucitti F. Surgery: Independent prognostic factor in curable and advanced gastric cancer. World J Surg 2000; 24: 459.
4. Hundahl S, Phillips J, Menck H. The national cancer database report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy. Cancer 2000; 88: 921.
5. Macdonald J, Smalley S, Benedetti J, Hundahl S, Estes N, Stemmerman G, Haller D, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001; 345: 725.
6. Karpeh M, Brennan M. Gastric carcinoma. Ann Surg Oncol 1998; 5: 650.
7. Rubio C, Befrits R. Gastric intestinal metaplasia. J Clin Pathol 2004; 57: 894.
8. Melguizo M. Metaplasia intestinal del cardias en pacientes con síntomas de reflujo gastroesofágico con o sin esofagitis. Rev Colomb Cir 2003; 18: 218.
9. Gaviria J, Melguizo M. Gastritis crónica. Correlación de la clasificación de Sydney con el diagnóstico endoscópico. Rev Col Cir 2004; 19: 162.
10. Fennerty MB. Gastric intestinal metaplasia on routine endoscopic biopsy. Gastroenterology 2003; 125: 586.
11. Rugge M, Genta R. Staging and grading of chronic gastritis. Hum Pathol 2005; 36: 228.
12. Lauren P. The two histological main types of gastric carcinoma: diffuse and the so-called intestinal-type carcinoma. Acta Pathol Microbiol Scand 1965; 64: 31.
13. Correa P, Cuello C, Duque E, Burbano L, García F, Bolaños O, et al. Gastric cancer in Colombia. III Natural History of precursor lesions. J Natl Cancer Inst 1976; 57: 1027.
14. Correa P, Haenszel W, Cuello C, Zavala D, Fontham E, Zarama G, Tannenbaum S, et al. Gastric precancerous process in a high risk population: Cohort Follow-up. Cancer Research 1990; 50: 4737.
15. Correa P, Haenszel W, Cuello C, Zavala D, Fontham E, Zarama G, Tannenbaum S, Collazos T, Ruiz B. Gastric precancerous process in a high risk population: Cross-sectional studies. Cancer Res 1990; 50: 4731.
16. El-Zimaity H, Ramchatesingh J, Ali Saeed M, Graham D. Gastric intestinal metaplasia: subtypes and natural history. J Clin Pathol 2001; 54: 679.
17. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process. First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res 1992; 52: 6735.
18. Guindi M, Riddell R. The pathology of epithelial pre-malignancy of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 2001; 12: 191.
19. Genta R, Rugge M. Gastric precancerous lesions: heading for an international consensus. Gut 1999; 45: 5.
20. Jablonská M, Chlumská A. Genetic factors in the development of gastric precancerous lesions - a role of Helicobacter pylori? J Physiol Paris 2001; 95: 477.
21. Conchillo J, Houben G, Bruïne A, Stockbrügger R. Is type III intestinal metaplasia an obligatory precancerous lesion in intestinal-type gastric carcinoma? Eur J Cancer Prev 2001; 10: 307.
22. Houghton J, Wang T. Helycobacter pylori and gastric cancer: a new paradigm for inflammation-associated epithelial cancers. Gastroenterology 2005; 128: 1567.
23. Nardone G, Rocco A, Malfertheiner P. Review article: Helicobacter pylori and molecular events in precancerous gastric lesions. Aliment Pharmacol Ther 2004; 20: 261.
24. Ohata H, Kitauchi S, Yoshimura N, Mugitani K, Iwane M, Nakamura H, Yoshikawa K, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer 2004; 109: 138.
25. Lahner E, Bordi C, Catarruza M, Iannonnis C, Milione M, Delle Fave G, Annibale B. Long-term follow-up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection. Aliment Pharmacol Ther 2005; 22: 471.
26. Ikeda Y, Nishikura K, Watanabe H, Watanabe G, Ajioka Y, Hatakeyama K. Histopathological differences in the development of small intestinal metaplasia between antrum and boy of stomach. Pathol Res Pract 2005; 201: 487.
27. Mera R, Fontham E, Bravo L, Bravo J, Piazuelo M, Camargo M, Correa P. Long term follow up of patients treated for Helicobacter pylori infection. Gut 2005; 54: 1536.
28. Kuipers E, Siersema P. The aetiology and clinical relevance of gastric intestinal metaplasia. Dig Liver Dis 2004; 36: 501.
29. Leung W, Lin S, Ching J, To K, Ng E, Chan F, Lau J, Sung J. Factors predicting progression of gastric intestinal metaplasia: results of a randomizes trial on Helicobacter pylori eradication. Gut 2004; 53: 1244.
30. Cassaro M, Rugge M, Gutierrez O, Leandro G, Graham D, Genta R. Topographic patterns of intestinal metaplasia and gastric cancer. Am J Gastroenterol 2000; 95: 1431.
31. Meining A, Morgner A, Mielhke S, Bayerdörfer E, Stolte M. Atrophy-metaplasia-dysplasia-carcinoma sequence in the stomach: a reality or merely an hypothesis?. Best Pract Res Clin Gastroenterol 2001; 15: 983.
32. Kokkola A, Sipponen P, Rautelin H, Härkönens H, Kosunen T, Haapiainen R, Polakkainen P. The effect of Helycobacter pylori erradication on the natural course of atrophic gastritis with dysplasia. Aliment Pharmacol Ther 2002; 16: 515.
33. Giuliani A, Caporale A, Demoro M, Benvenuto E, Scarpini M, Spada S, Angelico F. Gastric cancer precursor lesions and Helicobacter pylori infection in patients with partial gastrectomy for peptic ulcer. World J Surg 2005; 29: 1127.
34. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, Taniyama K, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001; 345: 784.
35. Correa P. Is gastric cancer preventable? Gut 2004; 53: 1217.
36. Sierra F. Helicobacter pylori - Estado actual. Rev Colomb Cir 2002; editorial 17 (3).
37. Zhang C, Yamada N, Wu Y, Wen M, Matsuhisa T, Matsukura N. Helicobacter pylori infection, glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer. World J Gastroenterol 2005; 11(6): 791.
38. Wong B, Lam S, Wong W, Chen J, Zheng T, Feng R, Lai K, et al. Helicobacter pylori erradication to prevent gastric cancer in a high-risk region of China a randomized controlled trial. JAMA 2004; 291: 187.
39. Correa P, Fontham E, Bravo J, Bravo L, Ruiz B, Zarama G, Realpe J, et al. Chemoprevention of gastric displasia: Randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy. J Natl Cancer Inst 2000; 92: 1881.
40. Fontham E, Correa P, Mera R, Bravo L, Bravo J, Piazuelo M, Camargo C. Duration of exposure, a neglected factor in chemoprevention trials. Cancer Epidemiol Biomarkers Prev 2005; 14 (11): 2465.
41. You W, Brown L, Zhang L, Li J, Jin M, Chang Y, Ma J, et al. Randomized double-blind factorial trial of three treatments to reduce prevalence of precancerous gastric lesions. J Natl Cancer Inst 2006; 98: 974
42. Lahner E, Caruana P, D´ambra G, Ferraro G, Di Giulio E, Delle Fave G, et al. First Endoscopic-histologic follow-up in patients with body-predominant atrophic gastritis: when should it be done? Gastrointest Endosc 2001; 53: 443.
43. Whiting J, Sigurdsson A, Rowlands D, Hallissey M, Fielding J. The long term results of endoscopic surveillance of premalignant gastric lesions. Gut 2002; 50: 378.
44. Dinis-Ribeiro M, Lopes C, Costa-Pereira A, Guilherme M, Barbosa J, Lomba-Viana H, Silva R, et al. A follow-up model for patients with atrophic chronic gastritis and intestinal metaplasia. J Clin Pathol 2004; 57: 177.
45. Jillian C, Herrera R, Tibshirani R, Yang S, Mohar A, Guarner J, Parsonnet J. Changes of gene expression in gastric preneoplasia following Helicobacter pylori eradication therapy. Cancer epidemiol Biomarkers Prev 2006; 15: 272.
46. Chang A, Peng J, Lai K, Yuen M, Cheung H, Kwong Y, Rashid A, et al. Eradication of Helicobacter pylori infection reverses E-cadherin promoter hypermethylation. Gut 2006; 55: 463.
47. Reis C, David L, Correa P, Carneiro F, Bolos C, García E, Mandel U, et al. Intestinal metaplasia of human stomach displays distinct patterns of mucin (MUC1, MUC2, MUC5A6 and MUC6) expression. Cancer Res 1999; 59: 1003.
48. Lacaine F. Evidence-based medicine in surgical decision making. Worl J Surg 2005; 29: 588.
49. Urschel J. How to analyze an article. Worl J Surg 2005; 29: 557.
2. Graham D, Shiotani A. The time to eradicate gastric cancer is now. Gut 2005; 54: 735.
3. Doglietto G, Pacelli F, Caprino P, Sgadari A, Crucitti F. Surgery: Independent prognostic factor in curable and advanced gastric cancer. World J Surg 2000; 24: 459.
4. Hundahl S, Phillips J, Menck H. The national cancer database report on poor survival of U.S. gastric carcinoma patients treated with gastrectomy. Cancer 2000; 88: 921.
5. Macdonald J, Smalley S, Benedetti J, Hundahl S, Estes N, Stemmerman G, Haller D, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001; 345: 725.
6. Karpeh M, Brennan M. Gastric carcinoma. Ann Surg Oncol 1998; 5: 650.
7. Rubio C, Befrits R. Gastric intestinal metaplasia. J Clin Pathol 2004; 57: 894.
8. Melguizo M. Metaplasia intestinal del cardias en pacientes con síntomas de reflujo gastroesofágico con o sin esofagitis. Rev Colomb Cir 2003; 18: 218.
9. Gaviria J, Melguizo M. Gastritis crónica. Correlación de la clasificación de Sydney con el diagnóstico endoscópico. Rev Col Cir 2004; 19: 162.
10. Fennerty MB. Gastric intestinal metaplasia on routine endoscopic biopsy. Gastroenterology 2003; 125: 586.
11. Rugge M, Genta R. Staging and grading of chronic gastritis. Hum Pathol 2005; 36: 228.
12. Lauren P. The two histological main types of gastric carcinoma: diffuse and the so-called intestinal-type carcinoma. Acta Pathol Microbiol Scand 1965; 64: 31.
13. Correa P, Cuello C, Duque E, Burbano L, García F, Bolaños O, et al. Gastric cancer in Colombia. III Natural History of precursor lesions. J Natl Cancer Inst 1976; 57: 1027.
14. Correa P, Haenszel W, Cuello C, Zavala D, Fontham E, Zarama G, Tannenbaum S, et al. Gastric precancerous process in a high risk population: Cohort Follow-up. Cancer Research 1990; 50: 4737.
15. Correa P, Haenszel W, Cuello C, Zavala D, Fontham E, Zarama G, Tannenbaum S, Collazos T, Ruiz B. Gastric precancerous process in a high risk population: Cross-sectional studies. Cancer Res 1990; 50: 4731.
16. El-Zimaity H, Ramchatesingh J, Ali Saeed M, Graham D. Gastric intestinal metaplasia: subtypes and natural history. J Clin Pathol 2001; 54: 679.
17. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process. First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res 1992; 52: 6735.
18. Guindi M, Riddell R. The pathology of epithelial pre-malignancy of the gastrointestinal tract. Best Pract Res Clin Gastroenterol 2001; 12: 191.
19. Genta R, Rugge M. Gastric precancerous lesions: heading for an international consensus. Gut 1999; 45: 5.
20. Jablonská M, Chlumská A. Genetic factors in the development of gastric precancerous lesions - a role of Helicobacter pylori? J Physiol Paris 2001; 95: 477.
21. Conchillo J, Houben G, Bruïne A, Stockbrügger R. Is type III intestinal metaplasia an obligatory precancerous lesion in intestinal-type gastric carcinoma? Eur J Cancer Prev 2001; 10: 307.
22. Houghton J, Wang T. Helycobacter pylori and gastric cancer: a new paradigm for inflammation-associated epithelial cancers. Gastroenterology 2005; 128: 1567.
23. Nardone G, Rocco A, Malfertheiner P. Review article: Helicobacter pylori and molecular events in precancerous gastric lesions. Aliment Pharmacol Ther 2004; 20: 261.
24. Ohata H, Kitauchi S, Yoshimura N, Mugitani K, Iwane M, Nakamura H, Yoshikawa K, et al. Progression of chronic atrophic gastritis associated with Helicobacter pylori infection increases risk of gastric cancer. Int J Cancer 2004; 109: 138.
25. Lahner E, Bordi C, Catarruza M, Iannonnis C, Milione M, Delle Fave G, Annibale B. Long-term follow-up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection. Aliment Pharmacol Ther 2005; 22: 471.
26. Ikeda Y, Nishikura K, Watanabe H, Watanabe G, Ajioka Y, Hatakeyama K. Histopathological differences in the development of small intestinal metaplasia between antrum and boy of stomach. Pathol Res Pract 2005; 201: 487.
27. Mera R, Fontham E, Bravo L, Bravo J, Piazuelo M, Camargo M, Correa P. Long term follow up of patients treated for Helicobacter pylori infection. Gut 2005; 54: 1536.
28. Kuipers E, Siersema P. The aetiology and clinical relevance of gastric intestinal metaplasia. Dig Liver Dis 2004; 36: 501.
29. Leung W, Lin S, Ching J, To K, Ng E, Chan F, Lau J, Sung J. Factors predicting progression of gastric intestinal metaplasia: results of a randomizes trial on Helicobacter pylori eradication. Gut 2004; 53: 1244.
30. Cassaro M, Rugge M, Gutierrez O, Leandro G, Graham D, Genta R. Topographic patterns of intestinal metaplasia and gastric cancer. Am J Gastroenterol 2000; 95: 1431.
31. Meining A, Morgner A, Mielhke S, Bayerdörfer E, Stolte M. Atrophy-metaplasia-dysplasia-carcinoma sequence in the stomach: a reality or merely an hypothesis?. Best Pract Res Clin Gastroenterol 2001; 15: 983.
32. Kokkola A, Sipponen P, Rautelin H, Härkönens H, Kosunen T, Haapiainen R, Polakkainen P. The effect of Helycobacter pylori erradication on the natural course of atrophic gastritis with dysplasia. Aliment Pharmacol Ther 2002; 16: 515.
33. Giuliani A, Caporale A, Demoro M, Benvenuto E, Scarpini M, Spada S, Angelico F. Gastric cancer precursor lesions and Helicobacter pylori infection in patients with partial gastrectomy for peptic ulcer. World J Surg 2005; 29: 1127.
34. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, Taniyama K, et al. Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001; 345: 784.
35. Correa P. Is gastric cancer preventable? Gut 2004; 53: 1217.
36. Sierra F. Helicobacter pylori - Estado actual. Rev Colomb Cir 2002; editorial 17 (3).
37. Zhang C, Yamada N, Wu Y, Wen M, Matsuhisa T, Matsukura N. Helicobacter pylori infection, glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer. World J Gastroenterol 2005; 11(6): 791.
38. Wong B, Lam S, Wong W, Chen J, Zheng T, Feng R, Lai K, et al. Helicobacter pylori erradication to prevent gastric cancer in a high-risk region of China a randomized controlled trial. JAMA 2004; 291: 187.
39. Correa P, Fontham E, Bravo J, Bravo L, Ruiz B, Zarama G, Realpe J, et al. Chemoprevention of gastric displasia: Randomized trial of antioxidant supplements and anti-Helicobacter pylori therapy. J Natl Cancer Inst 2000; 92: 1881.
40. Fontham E, Correa P, Mera R, Bravo L, Bravo J, Piazuelo M, Camargo C. Duration of exposure, a neglected factor in chemoprevention trials. Cancer Epidemiol Biomarkers Prev 2005; 14 (11): 2465.
41. You W, Brown L, Zhang L, Li J, Jin M, Chang Y, Ma J, et al. Randomized double-blind factorial trial of three treatments to reduce prevalence of precancerous gastric lesions. J Natl Cancer Inst 2006; 98: 974
42. Lahner E, Caruana P, D´ambra G, Ferraro G, Di Giulio E, Delle Fave G, et al. First Endoscopic-histologic follow-up in patients with body-predominant atrophic gastritis: when should it be done? Gastrointest Endosc 2001; 53: 443.
43. Whiting J, Sigurdsson A, Rowlands D, Hallissey M, Fielding J. The long term results of endoscopic surveillance of premalignant gastric lesions. Gut 2002; 50: 378.
44. Dinis-Ribeiro M, Lopes C, Costa-Pereira A, Guilherme M, Barbosa J, Lomba-Viana H, Silva R, et al. A follow-up model for patients with atrophic chronic gastritis and intestinal metaplasia. J Clin Pathol 2004; 57: 177.
45. Jillian C, Herrera R, Tibshirani R, Yang S, Mohar A, Guarner J, Parsonnet J. Changes of gene expression in gastric preneoplasia following Helicobacter pylori eradication therapy. Cancer epidemiol Biomarkers Prev 2006; 15: 272.
46. Chang A, Peng J, Lai K, Yuen M, Cheung H, Kwong Y, Rashid A, et al. Eradication of Helicobacter pylori infection reverses E-cadherin promoter hypermethylation. Gut 2006; 55: 463.
47. Reis C, David L, Correa P, Carneiro F, Bolos C, García E, Mandel U, et al. Intestinal metaplasia of human stomach displays distinct patterns of mucin (MUC1, MUC2, MUC5A6 and MUC6) expression. Cancer Res 1999; 59: 1003.
48. Lacaine F. Evidence-based medicine in surgical decision making. Worl J Surg 2005; 29: 588.
49. Urschel J. How to analyze an article. Worl J Surg 2005; 29: 557.
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Publicado
2007-03-20
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Rubiano Vinueza, R. V.; Velásquez Galvis, M. Atrofia, Metaplasia Y cáncer gástrico: ¿dónde Está La Evidencia?. Rev Colomb Cir 2007, 22, 39-46.
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