Revista: | Jornal brasileiro de patologia e medicina laboratorial |
Base de datos: | PERIÓDICA |
Número de sistema: | 000297287 |
ISSN: | 1676-2444 |
Autores: | Alvares, Monica Maria Demas1 Marino, Marilia Oliveira, Celso Affonso de Mendes, Claudia Castro Costa, Adriana de Cassia Ferreira Guerra, Juliana Queiroz, Dulciene Maria de Magalhaes Nogueira, Ana Margarida Miguel Ferreira |
Instituciones: | 1Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, Minas Gerais. Brasil |
Año: | 2006 |
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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