Helicobacter pyloriand Progressive Gastric Pathology that Predisposes to Gastric Cancer
| Autor: | Robert H. Gilman, Alberto Ramírez-Ramos, W M Spira, S Recavarren-Arce, J. Cok, Raúl León-Barúa, C Rodríguez, R. Berendson |
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| Rok vydání: | 1991 |
| Předmět: |
Gastritis
Atrophic medicine.medical_specialty Pathology Atrophic gastritis Population Chronic gastritis Gastroenterology Helicobacter Infections Stomach Neoplasms Internal medicine Peru Prevalence medicine Gastric mucosa Humans education Poverty education.field_of_study Helicobacter pylori biology business.industry Age Factors Intestinal metaplasia medicine.disease biology.organism_classification Gastric Dysplasia medicine.anatomical_structure Gastritis medicine.symptom business Precancerous Conditions |
| Zdroj: | Scandinavian Journal of Gastroenterology. 26:51-57 |
| ISSN: | 1502-7708 0036-5521 |
| DOI: | 10.3109/00365529109093208 |
| Popis: | Evidence is presented suggesting that infection by Helicobacter pylori triggers and continuously contributes to the pathophysiology of progressive gastric changes that can ultimately lead to gastric cancer. In Peru, especially in population groups of low socioeconomic status, infection by H. pylori begins earlier in life and is more prevalent and persistent than in developed countries. The infection produces a destructive lesion of the mucinous surface epithelium which probably enables other aggressive luminal factors to cause further mucosal damage. As a consequence, active chronic gastritis appears. The gastritis is of the superficial type at the beginning but may progressively change to atrophic. Chronic atrophic gastritis is found more frequently and at a younger age in dyspeptic patients with low socioeconomic status--that is, in patients having higher prevalence of persistent infection by H. pylori since earlier in life. When chronic atrophic gastritis becomes severe and extensive, hypochlorhydria ensues. Hypochlorhydria favors the appearance of bacterial overgrowth, nitrites, and N-nitroso compounds in the gastric lumen. N-nitroso compounds, because of their mutagenic-carcinogenic properties, probably induce gastric premalignant lesions like intestinal metaplasia and dysplasia of the gastric mucosa. Oral bismuth therapy apparently reverses H. pylori-associated gastric dysplasia. It is proposed that future programs designed for the control of gastric cancer would be incomplete if they do not include further evaluation of the many effects of infection by H. pylori on the gastric mucosa and of cost-effective methods to eradicate the infection. |
| Databáze: | OpenAIRE |
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