Helicobacter pylori and gastric premalignant lesions in patients with non-studied dyspepsia in a general hospital in Lima
DOI:
https://doi.org/10.36393/spmi.v31i4.3Keywords:
Helicobacter pylori, gastritis, dysplasia, metaplasia, prermalignancy, dyspepsiaAbstract
Objective. To determine the frequency of infection by Helicobacter pylori (HP) and premalignant gastric lesions (PGL) in patients with non-studied dyspepsia, in a general hospital
in Lima. Material and methods. It was carried out a descriptive, cross-sectional, retrospective study. The study population corresponded to outpatients referred to the Hospital EsSalud Uldarico Rocca Fernandez, Villa El Salvador, Lima, with a diagnosis of non-studied dyspepsia, who underwent upper gastrointestinal endoscopy between April 2012 and March 2014. Clinical and anatomopathological characteristics were evaluated. Results. 2 790 patients were studied, average age 48,6 (SD ± 15,3) year-old, range: 14-91 year-old. We found a global frequency of HP infection in 61,3 % (95%CI: 59,5-63,1) and premalignant gastric lesions in 23,6 % (95%CI: 22-25,1). A statistically significant association was found between patients with positive HP and PGL (chi square = 14,6, p < 0,01). The HP infection was 62,5% in those who had atrophic gastritis), 64,6 % in those with complete intestinal metaplasia, 56,8 % in those with incomplete intestinal metaplasia and 32,5 % in those with dysplasia. Conclusions. The frequency of Helicobacter pylori (HP) infection and premalignant gastric lesions was high in patients with non-studied dyspepsia undergoing endoscopy in the study population; and, only a significant association was found between HP with complete intestinal metaplasia and dysplasia.
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References
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31. Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/ Florence Consensus Report. Gut. 2016;0:1-25.
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34. Siddiqui ST, Naz E, Mirza T, et al. Frequency of Helicobacter pylori in biopsy proven gastritis and its association with lymphoid follicle formation. J Pak Med Assoc.2011;61(2):138-41.
35. Ramirez-Ramos A, Recavarren S, Arias Stella J, et al. Helicobacter pylori, gastritis crónica, úlcera gástrica y úlcera duodenal: Estudio de 1638 pacientes. Rev Gastroenterol Perú. 1999;19:196-201.
36. Prochazka R, Salazar F, Barriga E. Prevalencia de Helicobacter pylori en una clínica privada de Lima. Sensibilidad de las biopsias de antro y el cuerpo, y la prueba rápida de la ureasa. Rev Gastroenterol Peru. 2010; 30:33-9.
37. Kalebi A, Rana F, Mwanda W, et al. Histopathological profile of gastritis in adult patients seen at a referral hospital in Kenya. World J Gastroenterol. 2007;13(30):4117-21.
38. Ho YW, Ho KY, Ascencio F, Ho B. Neither gastric topological distribution nor principle virulence genes of Helicobacter pylori contributes to clinical outcomes. World J Gastroenterol. 2004;10(22):3274-77.
39. Sharma P, Kumar K, Mahajan M, et al. Histopathological changes in gastric mucosal biopsies in chronic gastritis and correlation of pathological features with Helicobacter pylori infection. Trop J Pathol Microbiol. 2015; 1 (1):8-15.
40. Hulten K, Han S, Enroth H, et al: Helicobacter in the drinking water in Peru. Gastroenterology, 1996;110:1031-1035.
41. Salas W, Benites M, Salinas C, et al. Asociación de Helicobacter pylori y patología gástrica no neoplásica en una clínica privada de Lima Norte. Rev Med Hered. 2005;16(2):89-96.
42. de Sablet T, Piazuelo MB, Shaffer CL, et al. Phylogeographic origin of Helicobacter pylori is a determinant of gastric cancer risk. Gut. 2011; 60: 1189-95.
43. Loh JT, Shaffer CL, Piazuelo MB, et al. Analysis of cagA in Helicobacter pylori strains from Colombian populations withcontrasting gastric cancer risk reveals a biomarker for disease severity. Cancer Epidemiol Biomarkers Prev. 2011;20:2237-49.
44. Matysiak-Budnik T, Megraud F. Helicobacter pylori infection and gastric cancer. Eur J Cancer. 2006;42(6):708-16.
45. MacDonald W, Owen D. Chronic atrophic gastritis, intestinal metaplasia of the stomach and partial gastrectomy. En: Eastwood G.L. (ed.). Premalignant conditions of the gastrointestinal tract. New York: Elsevier; 1991. p.145.
46. Necchi V, Candusso M, Tava F, et al. Intracellular, intercellular, and stromal invasion of gastric mucosa, preneoplastic lesions, and cancer by Helicobacter pylori. Gastroenterology. 2007;132(3):1009-1023.
47. Haziri A, Juniku-Shkololli A, Gashi Z, et al. Helicobacter pylori infection and precancerous lesions of the stomach. Med Arch. 2010;64(4):248-9.
48. Sugimoto M, Ban H, Ichikawa I, et al. Efficacy of the Kyoto classification of gastritis in identifying patients at high risk for gastric cancer. Intern Med. 2017;56:579-586.
2. Hammer J, Talley NJ. Nonulcer dyspepsia. Curr Opin Gastroenterol.2001;17:518-22.
3. Mahadeva S, Ford AC. Clinical and epidemiological differences in functional dispepsia between the East and the West. Neurogastroenterol Motil. 2016; 28:167-74.
4. Talley N, Vakil N. Practice Parameters Committee of the American College of Gastroenterology. Guidelines for the Management of Dyspepsia.Am J Gastroenterol. 2005; 100:2324–2337.
5. Almeida A, Martins L, Cunha P, et al. Prevalence of dyspeptic symptoms and heartburn of adults in Belo Horizonte, Brazil. Arq Gastroenterol. 2017;54(1):46-49.
6. Curioso W, Donaires N, Bacilio C. Prevalencia y asociación de la dispepsia y el síndrome de intestino irritable en una comunidad de la Selva Peruana. Rev Gastroenterol Perú. 2002; v.22 n.2.
7. Ford A, Marwaha A, Lim A, et al. What is the prevalence of clinically significant endoscopic findings in subjects with dyspepsia? Systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2010;8:830-7.
8. Ford A, Marwaha A, Sood R, et al. Global prevalence of, and risk factors for, uninvestigated dyspepsia: a metaanalysis. Gut. 2015;64:1049-57.
9. Moayyedi P, Forman D, Braunholtz D, et al. The proportion of upper gastrointestinal symptoms in the community associated with Helicobacter pylori, lifestyle factors, and nonsteroidal anti-inflammatory drugs.Am J Gastroenterol. 2000;95:1448-55
10. Cao Q, Didelot X, Wu Z, et al. Progressive genomic convergence of two Helicobacter pylori strains during mixed infection of a patient with chronic gastritis. Gut. 2015;64:554-561
11. Malfertheiner P, Megraud F, O'Morain C, et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut. 2012;61(5):646-64.
12. Organización Mundial de la Salud.World Cancer Report, 2014.
13. Ministerio de salud, Dirección general de epidemiología. Análisis de la Situación del Cáncer en el Perú, 2013.
14. Correa P, Piazuelo B.The gastric precancerous cascade. J Clin Exp Pathol. 2013;3:147.
15. Bonne C, Hartz P, Klerks J, et al. Morphology of the stomach and gastric secretion in Malays and Chinese and the different incidence of gastric ulcer and gastric cancer in these races.Am J Cancer. 1938;33:265-269.
16. Correa P, Cuello C, Duque E. Carcinoma and intestinal metaplasia of the stomach in Colombian migrants. J Natl Cancer Inst. 1970;44:297-306.
17. Fennerty MB, Emerson JC, Sampliner RE, et al. Gastric intestinal metaplasia in ethnic groups in the southwestern United States. Cancer Epidemiol Biomarkers Prev. 1992;1:293-296.
18. de Vries AC, van Grieken NC, Looman CW, et al. Gastric cancer risk in patients with premalignant gastric lesions: a nationwide cohort study in the Netherlands. Gastroenterology. 2008;134:945-952.
19. León R, Recavarren S, Ramírez A. El aporte peruano a la investigación sobre el Helicobacter pylori. Rev Med Hered. 1991;2(4):173-181
.
20. Dixon M, Genta R, Yardley J, et al. Classification and grading of gastritis. The Update Sydney System. Am J Surg Pathol. 1996;20(10):1161-118.
21. Chen XY, Hulst RWM, Bruno MJ, Ende A, Xiao SD, Tytgat GNJ et al. Interobserver variation in the histopathological scoring of Helicobacter pylori related gastritis. Clin Pathol. 1999;52:612-15.
22. Morera M, Rodríguez M. Dispepsia funcional: caracterización clínico epidemiológica y endoscópica. Rev. Ciencias Médicas. 2014;18:733-742.
23. Hunt R, Megraud F, Bazzoli F et al. Guías prácticas de la Organización Mundial de Gastroenterología: Helicobacter pylori en los países en desarrollo. Gastroenterol latinoam. 2010;21(2):165-181.
24. The Gastrointestinal Physiology Working Group of the Cayetano Heredia and The Johns Hopkins University. Ecology of Helicobacter pylori in Peru: infection rates in coastal, high altitude and jungle communities. Gut. 1992; 33:604-5.
25. Ramírez-Ramos A, Chinga E, Mendoza D, et al. Variación de la prevalencia del H. pylori en el Perú período (1985-2002), en una población de nivel socioeconómico medio y alto. Rev Gastroenterol Perú. 2003;23(2):92-8.
26. Muñoz A, Cok J, Bussalleu A, et al. Helicobacter pylori en niños atendidos en el Hospital Nacional Cayetano Heredia durante los años 2003 al 2006. Rev Gastroenterol Perú. 2008;28:109-118.
27. Chacaltana A, Rodríguez C, Urday C, et al. Lesiones gástricas preneoplásicas y Helicobacter pylori en despistaje endoscópico para cáncer gástrico en población de nivel socioeconómico medio y alto. Rev Gastroenterol Perú. 2009;29-3:218-225.
28. Ramírez-Ramos A, Gilman RH, Watanabe J, et al. Helicobacter pylori infection in long-term and short-term Japanese visitors to Peru. Lancet. 1994;344(8928):1017.
29. Ramírez-Ramos A, Gilman R, Watanabe J, Rosas A. Estudio de la epidemiología del Helicobacter pylori en el Perú: 20 años después. Acta Gastroenterol Latinoam. 2004;34(2):69-78.
30. Rodríguez W, Pareja A, Yushimito L et al. Omeprazol, amoxicilina y claritromicina en el tratamiento de Helicobacter pylori, en los regímenes de 7 y 10 días. Rev Gastroenterol Perú. 2003;23(3):177-83.
31. Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/ Florence Consensus Report. Gut. 2016;0:1-25.
32. Baena Diez JM, García Lareo M, Martí Fernández J, et al. Prevalencia de la infección por Helicobacter pylori en atención primaria: estudio seroepidemiológico. Aten Primaria. 2002;29(9):553-57.
33. Khalid H, Zubair A, Tariq Masood Malik, et al. A histopathologic analysis of chronic inflammatory infiltrate in patients of H. pylori associated chronic gastritis. Pak Armed Forces Med J. 2015;65(1):36-41
34. Siddiqui ST, Naz E, Mirza T, et al. Frequency of Helicobacter pylori in biopsy proven gastritis and its association with lymphoid follicle formation. J Pak Med Assoc.2011;61(2):138-41.
35. Ramirez-Ramos A, Recavarren S, Arias Stella J, et al. Helicobacter pylori, gastritis crónica, úlcera gástrica y úlcera duodenal: Estudio de 1638 pacientes. Rev Gastroenterol Perú. 1999;19:196-201.
36. Prochazka R, Salazar F, Barriga E. Prevalencia de Helicobacter pylori en una clínica privada de Lima. Sensibilidad de las biopsias de antro y el cuerpo, y la prueba rápida de la ureasa. Rev Gastroenterol Peru. 2010; 30:33-9.
37. Kalebi A, Rana F, Mwanda W, et al. Histopathological profile of gastritis in adult patients seen at a referral hospital in Kenya. World J Gastroenterol. 2007;13(30):4117-21.
38. Ho YW, Ho KY, Ascencio F, Ho B. Neither gastric topological distribution nor principle virulence genes of Helicobacter pylori contributes to clinical outcomes. World J Gastroenterol. 2004;10(22):3274-77.
39. Sharma P, Kumar K, Mahajan M, et al. Histopathological changes in gastric mucosal biopsies in chronic gastritis and correlation of pathological features with Helicobacter pylori infection. Trop J Pathol Microbiol. 2015; 1 (1):8-15.
40. Hulten K, Han S, Enroth H, et al: Helicobacter in the drinking water in Peru. Gastroenterology, 1996;110:1031-1035.
41. Salas W, Benites M, Salinas C, et al. Asociación de Helicobacter pylori y patología gástrica no neoplásica en una clínica privada de Lima Norte. Rev Med Hered. 2005;16(2):89-96.
42. de Sablet T, Piazuelo MB, Shaffer CL, et al. Phylogeographic origin of Helicobacter pylori is a determinant of gastric cancer risk. Gut. 2011; 60: 1189-95.
43. Loh JT, Shaffer CL, Piazuelo MB, et al. Analysis of cagA in Helicobacter pylori strains from Colombian populations withcontrasting gastric cancer risk reveals a biomarker for disease severity. Cancer Epidemiol Biomarkers Prev. 2011;20:2237-49.
44. Matysiak-Budnik T, Megraud F. Helicobacter pylori infection and gastric cancer. Eur J Cancer. 2006;42(6):708-16.
45. MacDonald W, Owen D. Chronic atrophic gastritis, intestinal metaplasia of the stomach and partial gastrectomy. En: Eastwood G.L. (ed.). Premalignant conditions of the gastrointestinal tract. New York: Elsevier; 1991. p.145.
46. Necchi V, Candusso M, Tava F, et al. Intracellular, intercellular, and stromal invasion of gastric mucosa, preneoplastic lesions, and cancer by Helicobacter pylori. Gastroenterology. 2007;132(3):1009-1023.
47. Haziri A, Juniku-Shkololli A, Gashi Z, et al. Helicobacter pylori infection and precancerous lesions of the stomach. Med Arch. 2010;64(4):248-9.
48. Sugimoto M, Ban H, Ichikawa I, et al. Efficacy of the Kyoto classification of gastritis in identifying patients at high risk for gastric cancer. Intern Med. 2017;56:579-586.
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2019-06-15
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Helicobacter pylori and gastric premalignant lesions in patients with non-studied dyspepsia in a general hospital in Lima. (2019). Revista De La Sociedad Peruana De Medicina Interna, 31(4), 128-136. https://doi.org/10.36393/spmi.v31i4.3
