Caracteristicas da gastrite cronica associada a Helicobacter pylori: aspectos topograficos, doencas associadas e correlacao com o status cagA



Título del documento: Caracteristicas da gastrite cronica associada a Helicobacter pylori: aspectos topograficos, doencas associadas e correlacao com o status cagA
Revista: Jornal brasileiro de patologia e medicina laboratorial
Base de datos: PERIÓDICA
Número de sistema: 000297287
ISSN: 1676-2444
Autores: 1






Instituciones: 1Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, Minas Gerais. Brasil
Año:
Periodo: Feb
Volumen: 42
Número: 1
Paginación: 51-59
País: Brasil
Idioma: Portugués
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés AIMS: We aimed to investigate the topographical pattern of H. pylori gastritis in relation to cagA status and association with duodenal ulcer (DU) and early gastric carcinoma (EGCa). MATERIALS AND METHOD: We studied chronic gastritis (CG) in 160 patients submitted to upper endoscopy and in 40 patients with EGCa submitted to gastrectomy. Samples were taken from the antrum and corpus in the lesser and greater curvatures, incisura and from the tumour and were processed routinely for histology and histochemistry for intestinal metaplasia (IM) characterisation. H. pylori was evaluated by histology, immunohistochemistry, culture, and PCR; cagA status was evaluated by polymerase chain reaction (PCR). CG was analyzed according to the updated Sydney System. In 130 patients a topographic study was conducted by the comparative analysis of the gastritis parameters among the areas and according to cagA status. RESULTS: CG was observed in 121 patients, 24 had UD and 14 were normal. cagA-positive strains were detected in 59 patients with GC, 17 DU and 24 EGCa. All gastritis parameters were significantly more intense in the cagA-positive group than in cagA-negative one. Infection by cagA-positive strains was associated with atrophy and IM. IM was significantly more intense in the middle portion of the lesser curvature in the antral mucosa. In CG or EGCa patients infected with cagA-positive strains, inflammation and activity compromised equally the antrum and distal corpus, whereas atrophy and IM were more frequently found in the antral mucosa. In DU, CG was antral-predominant irrespectively of cagA status. CONCLUSIONS: According to our data the topographical pattern of H. pylori-associated gastritis seems to be associated with cagA status. Precancerous lesions were significantly more intense in the antral lesser curvature, where most gastric carcinomas arise
Resumen en portugués Nos pacientes cagA-negativos a GC era predominantemente antral, e na UD a GC apresentava predominância antral, independentemente do status cagA. CONCLUSÕES: Nossos dados sugerem que o padrão de gastrite por H. pylori se relaciona com fatores de virulência da bactéria. As lesões pré-neoplásicas são significativamente mais intensas na pequena curvatura do antro médio, onde surge a maioria dos carcinomas gástricos (CaG)
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Gastroenterología,
Oncología,
Helicobacter pylori,
Gastritis crónica,
Infecciones bacterianas,
Patogenia,
CagA
Keyword: Medicine,
Diagnosis,
Gastroenterology,
Oncology,
Helicobacter pylori,
Chronic gastritis,
Bacterial infections,
Pathogenesis,
CagA
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