Gastritis crónica en el Hospital San Juan de Dios y Clínica Carlos Lleras Restrepo de Bogotá, Universidad Nacional de Colombia
Keywords:
gastritis crónica, atrofia, H pylori, carcinogénesis gástrica (es)chronic gastritis, atrophy, H pylori, gastric carcinogenesis (en)
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La patología gástrica inflamatoria es una causa importante de morbilidad en nuestro medio. Condiciones específicas como la gastritis crónica atrófica multifocal, la metaplasia intestinal y la displasia gástrica se encuentran asociadas con el proceso de múltiples pasos en el desarrollo del adenocarcinoma gástrico de tipo intestinal. En este estudio, descriptivo retrospectivo, se revisó el archivo de quirúrgicos del Hospital San Juan de Dios y de la Clínica Carlos Lleras Restrepo de Bogotá, en el periodo comprendido entre el 1 de enero de 1.999 y el31 de Mayo de 2.000, encontrando 9.349 casos. Dentro de éstos, la patología gástrica correspondió a 18,6% (1.742), de los cuales 1585 casos ( 90%) correspondieron a patología no tumoral Se seleccionaron 1.387 casos de los diferentes tipos de gastritis, los cuales fueron clasificados de acuerdo al sistema Sydney modificado del consenso internacional de Houston de 1994. Se encontró una asociación de gastritis crónica y H pylori del 74,62%. La gastritis crónica no atrófica se presentó más frecuentemente (73,46%), afectando personas entre los 40 y 60 años Ysu asociación con H pylori fue del 80%. La gastritis crónica atrófica ocupó el segundo lugar en frecuencia (26,46%), predominando en mujeres, y con una asociación significativa a infección por H Pylori (63,31 %).Todos los casos de displasia se presentaron asociados con gastritis crónica atrófica multifocal. Además, se encontró que la presencia de gastritis crónica atrófica multifocal y displasia representan un mayor riesgo relativo (2,2) de desarrollo de adenocarcinoma gástrico.
The inflammatory gastric pathology is a very important cause of morbidity in Colombia. Specific conditions sucb as multifocal atrophic chronic gastritis, intestinal metaplasia and dysplasia are associated with the development of gastric adenocarcinoma of intestinal type. In this report, we reviewed 9349 specimens from files of Hospital San Juan de Dios and Clínica Carlos Lleras Restrepo from Bogotá, Colombia, between January 11999 and May 312000. 18.6% (1742) of the cases corresponded to gastric pathology. 1585 cases (90%) corresponded to non tumoral gastric pathology; we selected 1387 cases gastritis of different types classified based on the modified Sydney System of the International consensus of Houston in 1994. We found an association between chronic gastritis and H.pylori infection in 74.62% of cases. Non-atrophic chronic gastritis was the most frequent pathology, affecting people between 40 and 60 years of age. Its association with the presence of H. pylori was 80%. Atrophic chronic gastritis was second in frequency (26.46%), with higher incidence in women, showing a significant association with the presence of H. pylori. All dysplasia cases were associated with multifocal atrophic chronic gastritis. A higher relative risk (2.2 - CI95%) for the development of gastric adenocarcinoma was found associated to the presence of multifocal atrophic chronic gastritis and dysplasia in the sample analyzed.
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