INTRODUCTION Genetic variability of Helicobacter pylori is associated with various gastrointestinal diseases; however, little is known regarding its interaction with sociodemographic and dietary factors in the development of premalignant lesions.OBJECTIVE To evaluate the association between Helicobacter genotypes, salt intake, and sociodemographic factors with precursor lesions of gastric malignancyMATERIALS AND METHODS An analytical study was conducted including cases (patients with gastric atrophy, intestinal metaplasia, and dysplasia) and controls (patients with non-atrophic gastritis). Sociodemographic information and salt intake habits were obtained using a questionnaire. Histopathological diagnosis was made according to the Sydney System. Genotypes cagA and vacA for H. pylori were established using polymerase chain reaction in paraffin blocks. ANOVA was used for analyzing quantitative variables. Categorical variables are presented as proportions and absolute frequencies. The effect of each variable on the outcome (premalignant lesion) is presented as OR and 95%CI. A p-value of <0.05 was considered as significant.RESULTS The genotype vacA/s1m1 increases the risk of developing precursor lesions of malignancy (OR: 3.82; 95%CI: 1.45–10.07; p = 0.007). Age and salt intake showed a positive interaction effect for the genotype s1m1 (adjusted OR: 5.19; 95%CI: 1.88–14.32; p = 0.001) and bacterial coinfection (adjusted OR: 3.2; 95%CI: 1.06–9.59; p = 0.038). The cagA genotype was not related with the development of premalignant lesions (OR: 1.21; 95%CI: 0.80–1.82; p = 0.361).CONCLUSIONS The vacA genotypes, age, and salt intake are indicators of the risk of premalignant lesions in the study population.

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The population studied had elevated frequencies of cytotoxic Helicobacter pylori strains and the iceA1 genotype was more frequent in follicular gastritis.

Reflecting on the perception of old age itself, for the group of epidemiologists in training, helped visualize their concerns, fears, expectations, and to reflect on their responsibilities and possibilities in providing scientific evidence to plan and make sound decisions for a dignified old age and aging of the population from Nariño.

Los tumores del estroma gastrointestinal (GIST) son las neoplasias mesenquimales más frecuentes del tracto digestivo. Los criterios de estadificación del riesgo, como angioinvasion, tamaño, infiltración y el índice mitótico, permiten realizar un adecuado diagnóstico y tratamiento. Se presenta un paciente masculino de 67 años de edad, quien consultó por hematemesis y melenas. Endoscópicamente se observó una masa en el estómago de 20x10x6 cm de diámetro de la cual se tomó biopsia para estudio. Al examen histopatológico se diagnósticó un GIST con invasión microscópica de la lámina propia y angioinvasión, estos dos componentes histopatológicos son escasamente tomados en cuenta para clasificar GIST; sin embargo, son muy importantes en este contexto, pues cambian el pronóstico de la enfermedad y con requerimiento de terapia adyuvante con imatinib. El desenlace del paciente fue favorable, debido a la conducta terapéutica establecida. El comportamiento biológico del GIST varía dependiendo de las características clínicas e histopatológicas. Este caso resalta los criterios de alto riesgo del GIST y la necesidad de modificar el tratamiento cuando están presentes.