RESUMO
Gastric cancer (GC) is the first cancer-related cause of death in Chile; however, no plan for GC early detection has been implemented in this country. The OLGA system characterizes gastritis from stages 0 to IV according to the risk of developing GC based on H. pylori infection, atrophy, metaplasia and GC. In this study, the performance of the OLGA system was evaluated in 485 Chilean patients receiving routine endoscopy to improve the detection of early GC or preneoplastic lesions. The results showed that OLGA scores, atrophy, metaplasia and GC increased significantly with age (p < 0.001). Conversely, H. pylori infection was higher in younger groups (p < 0.05). All gastric lesions were more frequent in men than women. The majority of patients with atrophy also had metaplasia (99%, p < 0.0001). Patients with H. pylori infection had more gastric atrophy and metaplasia than those without infection (p < 0.05). Of the 485 patients, 21 (4.3%) had GC, being 2.3 times more frequent among men than women and about 2/3 (14) were in OLGA stage ≥2. In addition, 19 (90%) GC patients had atrophy and 18 (85%) had metaplasia (p < 0.001). In conclusion, the OLGA system facilitated the evaluation of GC precursor lesions particularly in patients with an OLGA score > 2 between 45 and 56 years old, because this group showed atrophy and intestinal metaplasia more frequently. Therefore, biennial endoscopic surveillance of patients with an OLGA >2 can be an important health policy in Chile for diagnosing GC in its early stages and reducing mortality over the next two decades.
Assuntos
Detecção Precoce de Câncer/métodos , Gastrite/diagnóstico , Infecções por Helicobacter/complicações , Metaplasia/diagnóstico , Lesões Pré-Cancerosas/diagnóstico , Índice de Gravidade de Doença , Neoplasias Gástricas/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Seguimentos , Gastrite/etiologia , Gastrite/patologia , Infecções por Helicobacter/virologia , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Metaplasia/etiologia , Metaplasia/patologia , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/etiologia , Lesões Pré-Cancerosas/patologia , Prognóstico , Fatores de Risco , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/patologia , Adulto JovemRESUMO
Alterações degenerativas e metaplásicas são usualmente observadas no revestimento epitelial dos cistos odontogênicos. Nos tumores odontogênicos estes processos são considerados mais raros. Objetivo: demonstrar a presença de células claras no revestimento epitelial de uma série de lesões odontogênicas císticas. Métodos: realizou-se um estudo descritivo, em uma amostra de 22 lâminas histológicas, do total de lesões odontogênicas císticas procedentes do Laboratório de Patologia Bucal da Universidade Federal da Paraíba. As lâminas foram examinadas por dois avaliadores previamente calibrados e os blocos parafinados correspondentes às lesões em que se observaram células claras, foram novamente processados, e as lâminas foram coradas pela técnica do Ácido Periódico de Schiff após digestão pela diástase e avaliadas quanto à presença de células mucosas. Resultados: células contendo mucina estavam presentes em 12 (54,5 porcento) das lesões coradas pelo Ácido Periódico de Schiff com diástase. Células mucosas foram observadas em 5 (41,66 porcento) dos 12 casos de cistos radiculares, 1 (50 porcento) dos 2 casos de tumores odontogênicos ceratocísticos, nos 4 (100 porcento) casos de cistos dentígeros e em 2 (100 porcento) casos de ameloblastomas unicísticos. Células claras foram muitas vezes observadas em áreas de inflamação. Conclusão: na amostra estudada, células mucosas puderam ser evidenciadas ocasionalmente no epitélio de lesões odontogênicas císticas(AU)
Cambios metaplásicos y degenerativas se observan generalmente en el revestimiento epitelial de los quistes odontogénicos. En tumores odontogénicos estos procesos son considerados raros. Objetivo: demostrar la presencia de células claras en el epitelio de revestimiento de una serie de lesiones quísticas odontogénicas. Métodos: se realizó un estudio descriptivo, en una muestra de 22 cortes histológicos, del total de lesiones quísticas odontogénicas procedentes del Laboratorio de Patología Oral de la Universidad Federal de La Paraiba. Los cortes fueron examinados por dos examinadores calibrados previamente y los bloques de parafina correspondientes a las lesiones que se observaron con células claras se volvieran a procesar y los cortes fueron teñidos por el Ácido Periódico de Schiff después de la digestión por la diastasa y evaluados para la presencia de células mucosas. Resultados: células contiendo mucina estaban presentes en 12(54,5 por ciento) de las lesiones teñidas por el Ácido Periódico de Schiff con diastasa. Células mucosas fueran observadas en 5(41,66 por ciento) de los 12 casos de quistes radiculares, 1 (50 por ciento) de los 2 casos de tumores odontogénicos queratoquísticos, en los 4 (100 %) casos de quistes dentígeros y en los 2(100 por ciento) casos de ameloblastomas uniquísticos. Células claras fueron muchas veces observadas en zonas de inflamación. Conclusión: En la muestra estudiada, las células mucosas pudieron ser encontradas ocasionalmente en el epitelio de lesiones quísticas odontogénicas(AU)
Metaplastic and degenerative changes are usually observed in the epithelial lining of odontogenic cysts. These processes are considered rare in Odontogenic tumors. Objective: to demonstrate the presence of clear cells in the epithelial lining of a series of odontogenic cystic lesions. Methods: a descriptive study was done, in a sample of 22 histological slides of the total odontogenic cystic lesions originating from the Oral Pathology Laboratory at the Federal University of Paraiba. The slides were examined by two calibrated examiners and the paraffin blocks, corresponding to the lesions, where clear cells were observed, were re-processed and the slides were stained by the Periodic Acid-Schiff technique after digestion by diastase and evaluated for the presence of mucous cells. Results: mucin-containing cells were present in 12 (54,5 percent) of the stained lesions by Periodic Acid-Schiff technique with diastase. Mucous cells were observed in 5 (41.66 percent) of 12 root cysts cases, 1 (50 percent) of 2 keratocystic odontogenic tumors, in 4 (100 percent) cases of dentigerous cysts and in 2 (100 percent) cases of unicystic ameloblastomas. Clear cells were often observed in inflammation areas. Conclusion: In the study sample mucous cells could be evidenced occasionally in the epithelium of cystic odontogenic lesions(AU)
Assuntos
Humanos , Reação do Ácido Periódico de Schiff/métodos , Tumores Odontogênicos/patologia , Metaplasia/etiologia , Epidemiologia Descritiva , Estudos TransversaisRESUMO
CONTEXT: Intestinal metaplasia of the stomach is a lesion in which metaplasia of gastric epithelial cells occurs for an intestinal phenotype. Gastric intestinal metaplasia is a lesion associated with an increase in the risk of gastric carcinoma development. Epidemiologic studies indicate a relation between dietary habits and stomach cancer development, some habits increasing the risk for it, and others have a protective effect, suggesting that antioxidants, such as vitamins A, C, and E, decrease the risk of this type of cancer. The relationship of these alimentary factors and intestinal metaplasia is unknown. METHODS: It is a case-control, observational study in which 320 patients with functional dyspepsia, divided in two groups, were assessed. The case I group (individuals with intestinal metaplasia) had their dietary pattern compared to that of the control group, constituted of individuals similar to those in the case group but without intestinal metaplasia, through a food frequency questionnaire. RESULTS: The analysis of the dietary pattern of functional dyspeptic patients with intestinal metaplasia, and its comparison with those without intestinal metaplasia, showed a higher frequency of canned and smoked foods consumption in the first group and, on the other hand, a higher consumption of fruits and vegetables in patients without intestinal metaplasia. No effect of salt consumption was detected. CONCLUSIONS: The results obtained in this study suggest changes in the diet, with a decrease in the consumption of smoked and canned foods, and an increase in the consumption of fruits and vegetables, can lead to a diminution of gastric intestinal metaplasia cases.
Assuntos
Dispepsia/etiologia , Comportamento Alimentar , Intestinos/patologia , Estômago/patologia , Estudos de Casos e Controles , Humanos , Estudos Longitudinais , Metaplasia/etiologia , Metaplasia/prevenção & controle , Fatores de RiscoRESUMO
CONTEXT: Intestinal metaplasia of the stomach is a lesion in which metaplasia of gastric epithelial cells occurs for an intestinal phenotype. Gastric intestinal metaplasia is a lesion associated with an increase in the risk of gastric carcinoma development. Epidemiologic studies indicate a relation between dietary habits and stomach cancer development, some habits increasing the risk for it, and others have a protective effect, suggesting that antioxidants, such as vitamins A, C, and E, decrease the risk of this type of cancer. The relationship of these alimentary factors and intestinal metaplasia is unknown. METHODS: It is a case-control, observational study in which 320 patients with functional dyspepsia, divided in two groups, were assessed. The case I group (individuals with intestinal metaplasia) had their dietary pattern compared to that of the control group, constituted of individuals similar to those in the case group but without intestinal metaplasia, through a food frequency questionnaire. RESULTS: The analysis of the dietary pattern of functional dyspeptic patients with intestinal metaplasia, and its comparison with those without intestinal metaplasia, showed a higher frequency of canned and smoked foods consumption in the first group and, on the other hand, a higher consumption of fruits and vegetables in patients without intestinal metaplasia. No effect of salt consumption was detected. CONCLUSIONS: The results obtained in this study suggest changes in the diet, with a decrease in the consumption of smoked and canned foods, and an increase in the consumption of fruits and vegetables, can lead to a diminution of gastric intestinal metaplasia cases.
CONTEXTO: A metaplasia intestinal do estômago é uma lesão onde ocorre a metaplasia das células epiteliais gástricas para um fenótipo intestinal. A metaplasia intestinal gástrica é considerada uma lesão associada ao aumento do risco de desenvolvimento de carcinoma gástrico. Estudos epidemiológicos indicam uma relação entre hábitos alimentares e o risco de desenvolvimento de câncer de estômago: tanto podendo ter efeito carcinogênico gástrico, como fator protetor, sugerindo que os antioxidantes como as vitaminas A, C e E diminuem o risco desse tipo de câncer. Não se conhece a influência desses fatores alimentares na metaplasia intestinal gástrica. MATERIAL: Trata-se de estudo caso-controle, observacional, para o qual foram avaliados 320 pacientes com dispepsia funcional, separados em dois grupos, um grupo de casos I (indivíduos com metaplasia intestinal) teve seus hábitos alimentares comparados aos do grupo de casos-controle (sem metaplasia intestinal), através de um questionário de frequência de consumo alimentar. RESULTADOS: Ao analisarmos o padrão alimentar dos pacientes dispépticos funcionais com metaplasia intestinal e compará-lo com o padrão daqueles que não possuem metaplasia intestinal, constatou-se que os pacientes com metaplasia intestinal consomem mais alimentos como os enlatados e defumados, enquanto os pacientes sem metaplasia intestinal apresentam consumo expressivamente maior de frutas em geral e vegetais. Diferença no padrão de consumo de sal não foi identificada. CONCLUSÕES: Através dos resultados obtidos no presente estudo podemos supor que a modificação da dieta, por meio da diminuição na ingestão de alimentos como defumados e enlatados e acréscimo na ingestão de frutas e vegetais pode levar a diminuição de casos de metaplasia intestinal.
Assuntos
Humanos , Dispepsia/etiologia , Comportamento Alimentar , Intestinos/patologia , Estômago/patologia , Estudos de Casos e Controles , Estudos Longitudinais , Metaplasia/etiologia , Metaplasia/prevenção & controle , Fatores de RiscoRESUMO
Presentamos a una mujer de 75 años, con antecedente de psoriasis a grandes placas, de 40 años de evolución. Luego de múltiples tratamientos tópicos y sistémicos que mejoraron su dermatosis, se observaron placas amarillo-anaranjadas infiltradas, de localización paravertebral. El estudio histopatológico informó la presencia de adipocitos maduros en banda en dermis reticular. Se realizó el diagnóstico de metaplasia lipomatosa. En la piel, la metaplasia lipomatosa es sumamente infrecuente. Se postula que la metaplasia puede ocurrir como consecuencia de la inflamación crónica y severa de la piel.
We report the case of a 75 year-old woman who had been suffering from severe large-plaquepsoriasis during forty years. After multiple topical and systemic treatments her psoriasisimproved and yellowish-orange, dorsal, infiltrated plaques were observed.Histology of skin biopsies showed a band of mature adipocytes in the reticular dermis. Thediagnosis of lipomatous metaplasia was considered.Lipomatous metaplasia of the skin is very infrequent. Up to date, we have found only onereport, in which the authors hypothesize that it can occur as a consequence of severe chronic inflammation of the skin.
Assuntos
Humanos , Idoso , Feminino , Metaplasia/etiologia , Tecido Adiposo/patologia , Inflamação/complicações , Lipomatose/etiologia , Lipomatose/tratamento farmacológico , Pele/patologia , Psoríase/complicaçõesRESUMO
BACKGROUND: Esophageal metaplasia progression is a consequence of chronic gastroesophageal reflux (CGR). Patients with this condition are frequently infected by Helicobacter pylori and show several symptoms including gastritis as well as ulcer formation. In addition, they present an increased risk for the development of gastric adenocarcinoma. Several pathogenic markers for Helicobacter pylori such as ureC, vacA and cagA genes have been described. Evidence indicates that direct injury to the epithelial mucosa is caused by cytotoxins and enzymes codified by these genes. We undertook this study to establish a relationship between the presence of pathogenic Helicobacter pylori strains and the presence of metaplasia progression in patients with CGR. METHODS: We detected the presence of Helicobacter pylori cagA and vacA positive strains in patients with CGR. Using polymerase chain reaction, we analyzed 120 samples obtained from 60 patients with CGR and 60 control group patients, including samples from both anatomic areas: cardia and gastric antrum. RESULTS: We detected 56% of Helicobacter pylori positive patients; 57.5% of these patients were positive for either cagA(+) and/or vacA(+) Helicobacter pylori strains. Cardiac intestinal metaplasia was observed in 35% of the patients. A marked tendency was observed to develop cardiac intestinal metaplasia in those patients diagnosed with high-pathogenicity strains infected in both anatomic areas. CONCLUSIONS: These results suggest that infection with Helicobacter pylori can be considered a risk factor for developing gastric cardiac intestinal metaplasia.
Assuntos
Antígenos de Bactérias/genética , Proteínas de Bactérias/genética , Esôfago de Barrett/epidemiologia , Cárdia/patologia , Gastrite Atrófica/patologia , Infecções por Helicobacter/patologia , Helicobacter pylori/patogenicidade , Adulto , Idoso , Esôfago de Barrett/etiologia , Esôfago de Barrett/microbiologia , Esôfago de Barrett/patologia , Biópsia , Estudos Transversais , Feminino , Gastrite Atrófica/complicações , Gastrite Atrófica/microbiologia , Refluxo Gastroesofágico/complicações , Gastroscopia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Helicobacter pylori/genética , Helicobacter pylori/isolamento & purificação , Humanos , Masculino , Metaplasia/epidemiologia , Metaplasia/etiologia , Pessoa de Meia-Idade , Neutrófilos/patologia , Lesões Pré-Cancerosas/epidemiologia , Lesões Pré-Cancerosas/etiologia , Lesões Pré-Cancerosas/microbiologia , Lesões Pré-Cancerosas/patologia , Estudos Prospectivos , Especificidade da Espécie , Virulência , Adulto JovemAssuntos
Antibacterianos/uso terapêutico , Infecções por Helicobacter/tratamento farmacológico , Dispepsia/tratamento farmacológico , Dispepsia/etiologia , Gastrite Atrófica/tratamento farmacológico , Gastrite Atrófica/etiologia , Refluxo Gastroesofágico/tratamento farmacológico , Refluxo Gastroesofágico/etiologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/fisiopatologia , Humanos , Metaplasia/tratamento farmacológico , Metaplasia/etiologia , Úlcera Péptica/tratamento farmacológico , Úlcera Péptica/etiologiaRESUMO
Objetivo. Determinar si la exposición a la contaminación ambiental en Distrito Federal ocasiona cambios histopatológicos en la mucosa nasal y, de ser así, describir cuál es la alteración histológica más frecuente. Método. Reporte de 33 biopsias de cornete inferior de adultos habitantes de la zona noroeste del área conurbada del Distrito Federal. Rango de edad 15 a 50 años. Se dividieron en dos grupos: Quince individuos expuestos a contaminación ambiental durante 10.5 ñ 0.3 horas diarias y 18 sujetos no expuestos. Resultados. Hubo cambios histopatológicos en todos los individuos, predominando la inflamación crónica y la metaplasia escamosa en ambos grupos. Conclusiones. El tiempo de exposición a la contaminación ambiental no dio diferencias estadísticamente signficativas en los hallazgos histopatológicos entre ambos grupos. La exposición a la contaminación ambiental desarrolla cambios histopatológicos en la mucosa nasal
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Poluição Ambiental/efeitos adversos , Inflamação/etiologia , Metaplasia/etiologia , Mucosa Nasal/patologia , Conchas Nasais/patologia , Exposição Ambiental/efeitos adversos , México/epidemiologia , Fatores de Tempo , População UrbanaRESUMO
BACKGROUND: The diagnosis of patients with short segments of intestinal metaplasia in the distal esophagus, has increased in recent years. AIM: To assess the clinical, pathological and functional features of patients with esophageal intestinal metaplasia. PATIENTS AND METHODS: A prospective study was performed in 95 control subjects, 115 patients with cardial intestinal metaplasia and 89 patients with short Barret esophagus with intestinal metaplasia. All had clinical and endoscopic assessments, esophageal manometry and determination of 24 h esophageal exposure to acid and duodenal content. RESULTS: Control patients were younger and, in this group, the pathological findings in the mucosa distal to the squamous-columnar change, showed a preponderance of fundic over cardial mucosa. In patients with intestinal metaplasia and short Barret esophagus, there was only cardial mucosa, that is the place where intestinal metaplasia implants. Low grade dysplasia was only seen in the presence of intestinal metaplasia. Gastroesophageal sphincter pressure decreased and gastric and duodenal reflux increased along with increases in the extension of intestinal metaplasia. CONCLUSIONS: These findings confirm the need to obtain multiple biopsies from the squamous-columnar mucosal junction in all patients with gastroesophageal reflux symptoms, for the detection of early pathological changes of Barret esophagus and eventual dysplasia.