Year 2016 / Volume 108 / Number 12
Original
Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico

770-775

DOI: 10.17235/reed.2016.4194/2016

Jaime Alberto Sánchez Cuén, Ana Bertha Irineo Cabrales, Gregorio Bernal Magaña, Felipe Peraza Garay,

Abstract
Background: Intestinal metaplasia is a precursor lesion of gastric cancer. Infection by Helicobacter pylori is the principal cause of metaplasia. While evidence of the regression of metaplasia after treatment to eradicate this infection has been demonstrated, controversy remains with regard to this subject. Objective: The objective of this study was to determine the frequency of the regression of gastric intestinal metaplasia one year after the eradication of Helicobacter pylori. Methods: A prospective longitudinal designed study was carried out. The population studied in this research consisted of patients attending the Endoscopy Unit to undergo an upper endoscopy, in whom various symptoms indicated intestinal metaplasia associated with Helicobacter pylori, and who received standard empiric triple therapy to eradicate the bacteria. An upper endoscopy was performed in which four gastric biopsy samples were taken (two from the antrum and two from the body) before and after the eradicating treatment, with the endoscopic and histological findings studied after one year of monitoring. The statistical analysis was conducted using the Fisher’s exact test and the McNemar’s test. Results: Forty-six patients were studied, of whom 20 (43.5%) were men and 26 (56.5%) were women, with an average age of 58.9 (DE 11.2). Intestinal metaplasia was found in 46 (100%) patients before treatment and in 21 (45.7%) patients post-eradication. Complete intestinal metaplasia (type I) was found in 35 patients (76.1%) before treatment and in 11 (23.9%) patients post-eradication (p = 0.000), while incomplete intestinal metaplasia (type II) was found in 10 (21.7%) patients before treatment and in 10 (21.7%) patients post-eradication. Non-atrophic chronic gastritis was found in 35 (76.1%) patients before treatment and in 32 (69.6%) patients post-eradication. Conclusions: In this study, gastric intestinal metaplasia associated with Helicobacter pylori infection showed a regression of 54.3% one year after the eradication of this microorganism. This treatment could modify the natural history of the development of gastric cancer.
Share Button
New comment
Comments

13/05/2021 22:44:27
Me interesa la información, trabajo en el sector salud y me gusta estar en revisión constante para actualizarme académicamente. Gracias


References
1. Marshall BJ, Warren JR. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet 1983; 1:1273-5.
2. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med 2002; 347(15):1175-86.
3. Greenberg ER, Anderson GL, Morgan DR, et al. 14-day triple, 5-day concomitant, and 10-day sequential therapies for Helicobacter pylori infection in seven Latin American sites: a randomised trial. Lancet 2011; 378 (9790):507-14.
4. Schistosomes, liver flukes and Helicobacter pylori. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Lyon, 7-14 June 1994. IARC Monogr Eval Carcinog Risks Hum 1994; 61:1–241.
5. Correa P, Piazuelo MB, Camargo MC. Etiopathogenesis of gastric cancer. Scand J Surg 2006; 95 (4): 218-24.
6. Conteduca V, Sansonno D, Lauletta G, et al. H. pylori infection and gastric cancer: state of the art (review). Int J Oncol 2013; 42(1):5-18.
7. Fuentes-Pananá E, Camorlinga–Ponce M, Maldonado-Bernal C. Infection, inflammation and gastric cancer. Salud Publica Mex 2009; 51 (5): 427-33.
8. Jass JR, Filipe MI. The mucin profiles of normal gastric mucosa, intestinal metaplasia and its variants and gastric carcinoma. Histochem J 1981; 13(6):931-9.
9. Quingalahua Flores Aldo, Mendoza Jaime Francisco. Helicobacter pylori, metaplasia intestinal de estómago y cáncer gástrico. Oncología 2004; 14 (1):64-67.
10. Piñol Jiménez Felipe, Paniagua Estévez Manuel, Pérez Sánchez Gloria, et al. Metaplasia intestinal en pacientes con reflujo duodenogástrico y ácidos biliares totales elevados. Rev cubana med 2010; 49(1): 17-32.
11. Kim N, Park YS, Cho SI, et al. Prevalence and risk factors of atrophic gastritis and intestinal metaplasia in a Korean population without significant gastroduodenal disease. Helicobacter 2008; 13:245-55.
12. Joo YE, Park HK, Myung DS, et al. Prevalence and risk factors of atrophic gastritis and intestinal metaplasia: a nationwide multicenter prospective study in Korea. Gut Liver 2013; 7(3):303-10.
13. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process--First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res 1992; 52: 6735-40.
14. Kim N, Park RY, Cho SI, et al. Helicobacter pylori infection and development of gastric cancer in Korea: long-term follow-up. J Clin Gastroenterol 2008; 42: 448-54.
15. Park YH, Kim N. Review of atrophic gastritis and intestinal metaplasia as a premalignant lesion of gastric cancer. J Cancer Prev 2015; 20(1): 25-40.
16. A review of Human Carcinogens. B. Biological Agents. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Lyon, 24 February-3 March 2009. IARC Monogr Eval Carcinog Risks Hum 2012; 100(B): 385-423.
17. Micu G, Stăniceanu F, Zurac S, et al. Regression of precancerous epithelial alteration in patients with Helicobacter pylori chronic gastritis. Rom J Intern Med 2010; 48(1):89-99.
18. Lahner E, Bordi C, Cattaruzza MS, et al. Long term follow-up in atrophic body gastritis patients: atrophy and intestinal metaplasia are persistent lesions irrespective of Helicobacter pylori infection. Aliment Pharmacol Ther 2005; 22: 471 – 481.
19. Wang J, Xu L, Shi R, et al. Gastric atrophy and intestinal metaplasia before and after Helicobacter pylori eradication: a meta-analysis. Digestion 2011; 83: 253 –260.
20. Vázquez Romero M, Boixeda de Miquel D, Valer López-Fando MP, et al. Intestinal metaplasia: evolution after Helicobacter pylori eradication and influence in the success of eradicating therapy. Rev Esp Enferm Dig 2003; 95(11):781-4.
21. Mearin F, Calleja JL. Defining functional dyspepsia. Rev Esp Enferm Dig 2011; 103 (12): 640-7.
22. Correa P, Bravo L. Investigaciones sobre cáncer gástrico en Nariño. Rev Med Hospital Universitario Departamental de Nariño 2007; 3: 6-12.
23. Correa P, Piazuelo MB. The gastric precancerous cascade. J Dig Dis 2012; 13 (1): 2-9.
24. Salas Caudevilla A. Evaluation of dysplasia in gastrointestinal diseases. Gastroenterol Hepatol 2007; 30(10):602-11.
25. Valdivia Roldán M. Gastritis and gastropathies. Rev Gastroenterol Peru 2011; 31(1):38-48.
26. Peetsalu A, Kirsimägi U, Peetsalu M. Giant peptic ulcer hemorrhages: epidemiology, treatment, and outcome in the teaching hospital of Tartu. Medicina (Kaunas) 2011; 47(1):19-24.
27. Abdo-Francis JM, Uscanga-Domínguez LF, Sobrino-Cossio S, et al. Tercer Consenso Mexicano de Helicobacter pylori. Rev Gastroenterol Mex 2007; 72(3):321-338.
28. Calle Astudillo G, Jerves T, Pesántez L, et al. Utility of routine gastric biopsies and staining with methylene blue in the diagnosis of intestinal metaplasia in patients over 40 years. Acta Gastroenterol Latinoam 2013; 43(3):189-97.
29. Monés J, Rodrigo L, Sancho F, et al . Helicobacter pylori eradication versus one-year maintenance therapy: effect on relapse and gastritis outcome. Rev Esp Enferm Dig 2001; 93(6):372-89.
30. Massarrat S, Haj-Sheykholeslami A, Mohamadkhani A, et al. Precancerous conditions after H. pylori eradication: a randomized double blind study in first degree relatives of gastric cancer patients. Arch Iran Med 2012; 15 (11): 664-9.
Related articles

Digestive Diseases Image

Esophageal epidermoid metaplasia. An unusual find

DOI: 10.17235/reed.2022.8805/2022

Digestive Diseases Image

Esophageal epidermoid metaplasia: an unusual condition

DOI: 10.17235/reed.2022.8708/2022

Special Article

V Spanish Consensus Conference on Helicobacter pylori infection treatment

DOI: 10.17235/reed.2021.8358/2021

Letter

Bone metaplasia in ovarian metastasis of colorectal carcinoma

DOI: 10.17235/reed.2021.8257/2021

Letter

Bone metaplasia in a rectal polyp

DOI: 10.17235/reed.2020.7414/2020

Letter to the Editor

A question about dyspeptic patients analyzed using psychometric scores

DOI: 10.17235/reed.2017.5401/2017

Letter to the Editor

Acute psychotic episode secondary to Helicobacter pylori eradication treatment

DOI: 10.17235/reed.2017.4482/2016

Citation tools
Sánchez Cuén J, Irineo Cabrales A, Bernal Magaña G, Peraza Garay F. Regression of gastric intestinal metaplasia after the eradication of Helicobacter pylori infection in a hospital in Mexico. 4194/2016


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1329 visits.
This article has been downloaded 452 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 05/01/2016

Accepted: 03/06/2016

Online First: 02/11/2016

Published: 30/11/2016

Article revision time: 142 days

Article Online First time: 302 days

Article editing time: 330 days


Share
This article has been rated by 4 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology