Avaliação da prevalência da infecção por helicobacter pylori em pacientes portadores de câncer gástrico

Rangel, Marcelo Fernandes; Amorim, Welma Wildes; Amorim, M.; Amorim, Pedro Duques de; Nóbrega, Leonardo Pires de Sá

doi:10.1590/s0100-69912003000100007

Cited by 1 publication

(1 citation statement)

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“…Apart from that, the effects of PPIs are more easily detected on patients infected by Hp than on those not infected. Keeping this and the reversibility of the correspondent gastric variations in mind, the suggestion of the eradication of Hp on patients under continued and prolonged PPI based treatment is justified 2,3,5,6,7,19,25 . Of potential importance is the observations that some patients under prolonged PPI based therapies develop glandular atrophy of the gastric body.…”

Section: Discussionmentioning

confidence: 99%

Análise qualitativa das alterações anatomopatológicas na mucosa gástrica decorrentes da terapêutica prolongada com inibidores da bomba de prótons: estudos experimentais x estudos clínicos

Souza

Silva

Araújo

et al. 2013

ABCD, arq. bras. cir. dig.

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-Introduction: For a few decades the long-term use of proton pump inhibitors has had wide application in the treatment of several gastrointestinal diseases. Since then, however, several studies have called attention to the possible development of anatomical and pathological changes of gastric mucosa, resulting from the long term use of this therapeutic modality. Recent experimental and clinical studies suggest that these changes have connection not only to the development of precancerous lesions, but also of gastric tumors. Objective: To present a qualitative analysis of anatomical and pathological changes of gastric mucosa resulting from the long-term use of proton pump inhibitors. Method: The headings used were: proton pump inhibitors, precancerous lesions and gastric neoplasms for a non systematic review of the literature, based on Medline, Lillacs and Scielo. Twelve articles were selected from clinical (9) and experimental (3) studies, for qualitative analysis of the results. Results: The gastric acid suppression by high doses of proton pump inhibitors induces hypergastrinemia and the consequent emergence of neuroendocrine tumors in animal models. Morphological changes most often found in these experimental studies were: enterochromaffin-like cell hyperplasia, neuroendocrine tumor, atrophy, metaplasia and adenocarcinoma. In the studies in humans, however, despite enterochromaffin-like cell hyperplasia, the other effects, neuroendocrine tumor and gastric atrophy, gastric metaplasia and or adenocarcinoma, were not identified. Conclusion: Although it is not possible to say that the long-term treatment with proton pump inhibitors induces the appearance or accelerates the development of gastric cancer in humans, several authors have suggested that prolonged administration of this drug could provoke the development of gastric cancer. Thus, the evidence demonstrated in the animal model as well as the large number of patients who do or will do a long-term treatment with proton pump inhibitors, justifies the maintenance of this important line of research. RESUMO -Introdução:Há algumas décadas o uso prolongado de inibidores de bomba de prótons tem tido ampla aplicação no tratamento de doenças gastrointestinais. Desde então, entretanto, vários estudos têm alertado para o possível desenvolvimento de alterações anatomopatológicas da mucosa gástrica, decorrentes do uso prolongado desta modalidade terapêutica. Estudos clínicos e experimentais recentes sugerem que estas alterações teriam relação com o desenvolvimento não só de lesões pré-neoplásicas mas, também, de tumores gástricos. Objetivo: Apresentar uma análise qualitativa das alterações antomopatológicas da mucosa gástrica decorrentes do uso prolongado dos inibidores da bomba de prótons. Métodos -Foram utilizados os descritores inibidores da bomba de prótons, lesões pré-neoplásicas e neoplasias gástricas para revisão não sistemática narrativa da literatura, com base nas plataformas Medline, Lillacs e Scielo. Foram selecionados 12 artigos, dentre estudos clíni...

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