RESUMEN

INTRODUCTION: Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk. METHODS: PubMed, Embase, and Cochrane databases were searched for prospective cohort studies that compared the highest vs the lowest level of UPF consumption according to NOVA food classification and reported the risk of gastrointestinal cancers by subsite. The association with cancer was quantified as hazard ratios (HR) using a random-effects model. RESULTS: Five prospective cohort studies were included in this review comprising 1,128,243 participants (241,201 participants in the highest and 223,366 in the lowest levels of UPF consumption). The mean follow-up ranged from 5.4 to 28 years. The highest UPF consumption was significantly associated with an increased risk of colorectal cancer (HR 1.11; 95% confidence interval [CI] 1.03-1.21; P = 0.01; I2 = 31%), colon cancer (HR 1.12; 95% CI 1.02-1.23; P = 0.02; I2 = 0%), and non-cardia gastric cancer (HR 1.43; 95% CI 1.02-2.00; P = 0.04; I2 = 0%) compared with the lowest UPF intake. However, no association was found between high UPF consumption and hepatocellular, esophageal, pancreatic, gastric cardia, and rectal cancer. DISCUSSION: The highest level of UPF consumption was significantly associated with colorectal and non-cardia gastric cancer.

Asunto(s)

Comida Rápida , Neoplasias Gastrointestinales , Humanos , Neoplasias Gastrointestinales/epidemiología , Neoplasias Gastrointestinales/etiología , Comida Rápida/efectos adversos , Factores de Riesgo , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/etiología , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología , Alimentos Procesados

RESUMEN

Of the chronic bacterial infections that affect humans, Helicobacter pylori (H. pylori) infection is one of the most common. It inhabits the stomachs of half of the adult human population. In Puerto Rico, a US territory, it has an overall prevalence of 33%, similar to the prevalence reported in the population of the US as a whole. Helicobacter pylori infection is responsible for mucosal inflammation that may lead to chronic gastritis, most peptic ulcers, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. The International Agency for Research on Cancer identified H. pylori as a definite carcinogen in 1994, the only bacterium to be given such a classification. Its oncogenic effect has been postulated to be caused by different mechanisms, including bacterial characteristics and host factors. Epidemiologic studies have shown that gastric cancer risk differs among regions. One of the top 10 causes of cancer death in Puerto Rico is gastric cancer. Although the eradication of H. pylori has well-known benefits, there are some concerns when considering mass screening and treatment of infected patients. These include the fact that such eradication could provoke an increase in antibiotic resistance rates, the disturbance of the gut microbiota, an increase in body weight, and the aggravation of existing gastroesophageal reflux symptoms. Gastric cancer is a major health concern, and we should understand the role of H. pylori eradication in its prevention. This article is geared to summarize current knowledge and controversies.

Asunto(s)

Gastritis Atrófica , Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Adulto , Humanos , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/epidemiología , Gastritis Atrófica/complicaciones , Gastritis Atrófica/microbiología , Gastritis Atrófica/patología , Puerto Rico

RESUMEN

Biomass cookstove food preparation is linked to aero-digestive cancers, mediated by ingested and inhaled carcinogens (e.g., heterocyclic amines, and polycyclic aromatic hydrocarbons). We investigated the association between gastric adenocarcinoma, wood cookstove use, H. pylori CagA infection and risk modification by variants in genes that metabolize and affect the internal dose of carcinogens. We conducted a population-based, case-control study (814 incident cases, 1049 controls) in rural Honduras, a high-incidence region with a homogeneous diet and endemic H. pylori infection, primarily with the high-risk CagA genotype. We investigated factors including wood cookstove use, H. pylori CagA serostatus, and 15 variants from 7 metabolizing genes, and the interactions between wood stove use and the genetic variants. Male sex (OR 2.0, 1.6-2.6), age (OR 1.04, 1.03-1.05), wood cookstove use (OR 2.3, 1.6-3.3), and CagA serostatus (OR 3.5, 2.4-5.1) and two SNPs in CYP1B1 (rs1800440 and rs1056836) were independently associated with gastric cancer in multivariate analysis. In the final multivariate model, a highly significant interaction (OR 3.1, 1.2-7.8) was noted between wood cookstove use and the rs1800440 metabolizing genotype, highlighting an important gene-environment interaction. Lifetime wood cookstove use associates with gastric cancer risk in the high-incidence regions of Central America, and the association is dependent on the rs1800440 genotype in CYP1B1. H. pylori CagA infection, wood cookstove use and the rs1800440 genotype, all of which are highly prevalent, informs who is at greatest risk from biomass cookstove use.

Asunto(s)

Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Masculino , Humanos , Neoplasias Gástricas/etiología , Neoplasias Gástricas/genética , Factores de Riesgo , Estudios de Casos y Controles , Madera , Genotipo , América Central , Helicobacter pylori/genética , Infecciones por Helicobacter/complicaciones , Proteínas Bacterianas/genética , Antígenos Bacterianos/genética

RESUMEN

EBV and Helicobacter pylori (H. pylori) cause highly prevalent persistent infections as early as in childhood. Both pathogens are associated with gastric carcinogenesis. H. pylori interferes with iron metabolism, enhancing the synthesis of acute-phase proteins hepcidin, C-reactive protein (CRP), and α-1 glycoprotein (AGP), but we do not know whether EBV does the same. In this study, we correlated the EBV antibody levels and the serum levels of hepcidin, CRP, and AGP in 145 children from boarding schools in Mexico City. We found that children IgG positive to EBV antigens (VCA, EBNA1, and EA) presented hepcidin, AGP, and CRP levels higher than uninfected children. Hepcidin and AGP remained high in children solely infected with EBV, while CRP was only significantly high in coinfected children. We observed positive correlations between hepcidin and EBV IgG antibodies (p < 0.5). Using the TCGA gastric cancer database, we also observed an association between EBV and hepcidin upregulation. The TCGA database also allowed us to analyze the two important pathways controlling hepcidin expression, BMP−SMAD and IL-1ß/IL-6. We observed only the IL-1ß/IL-6-dependent inflammatory pathway being significantly associated with EBV infection. We showed here for the first time an association between EBV and enhanced levels of hepcidin. Further studies should consider EBV when evaluating iron metabolism and anemia, and whether in the long run this is an important mechanism of undernourishment and EBV gastric carcinogenesis.

Asunto(s)

Infecciones por Virus de Epstein-Barr , Helicobacter pylori , Neoplasias Gástricas , Niño , Humanos , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Infecciones por Virus de Epstein-Barr/sangre , Infecciones por Virus de Epstein-Barr/metabolismo , Helicobacter pylori/metabolismo , Hepcidinas/metabolismo , Herpesvirus Humano 4 , Inmunoglobulina G/metabolismo , Interleucina-6/metabolismo , Hierro/metabolismo , Neoplasias Gástricas/etiología

RESUMEN

Gastric adenocarcinoma (GC) is the fourth leading cause of global cancer mortality, and the leading infection-associated cancer. Helicobacter pylori is the dominant risk factor for GC and classified as an IARC class I carcinogen. Surveillance of gastric premalignant conditions is now indicated in high-risk patients. Upper endoscopy is the gold standard for GC diagnosis, and image-enhanced endoscopy increases the detection of gastric premalignant conditions and early gastric cancer (EGC). Clinical staging is crucial for treatment approach, defining early gastric cancer, operable locoregional disease, and advanced GC. Endoscopic submucosal dissection is the treatment of choice for most EGC. Targeted therapies are rapidly evolving, based on biomarkers including MSI/dMMR, HER2, and PD-L1. These advancements in surveillance, diagnostic and therapeutic strategies are expected to improve GC survival rates in the near term.

Asunto(s)

Infecciones por Helicobacter , Helicobacter pylori , Lesiones Precancerosas , Neoplasias Gástricas , Antígeno B7-H1/uso terapéutico , Carcinógenos , Mucosa Gástrica/patología , Gastroscopía , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/tratamiento farmacológico , Humanos , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/patología , Lesiones Precancerosas/terapia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/etiología , Neoplasias Gástricas/prevención & control

RESUMEN

Helicobacter pylori (H. pylori) infection involves multiple factors internal and external to the host. Among the internal factors, the immune response plays a fundamental role in the process of antigen presentation, lymphocytic response and cytokine-mediated regulatory response that are directly as sociated with disease progression and prognosis. OBJECTIVE: To compare the immune response in gas tric mucosa of H. pylori infected patients in two regions comparing the risk of developing gastric can cer. PATIENTS AND METHOD: 71 participants with symptoms of dyspepsia were included. The samples for biopsies were collected from different regions of the gastric mucosa; the identification of H. pylori was carried out by culture and polymerase chain reaction (PCR) of the ureA gene. For the characteri zation of the histopathological alterations and the immunophenotyping of lymphocytes, anti-human mouse monoclonal antibodies specific for each antigen were used: T lymphocytes: CD3 and CD8; B lymphocytes: CD20; Natural Killer Cells: CD56; Macrophages: CD68. RESULTS: The prevalence of H. pylori was 83.1%, the predominant types of gastritis were chronic gastritis and multifocal atrophic gastritis with intestinal metaplasia (63.4% and 22.5%, respectively). The cellular response was charac terized mainly by polymorphonuclear lymphocytes and positive anti-CD8 reactivity both in stroma and epithelium. CONCLUSIONS: Multifocal atrophic gastritis was more prevalent in the high-risk region for gastric cancer (GC) while non-atrophic gastritis and the expression of CD3 and CD8 antigens in the foveolar epithelium was higher in the low-risk region.

Asunto(s)

Gastritis Atrófica , Gastritis , Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Animales , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patología , Gastritis/metabolismo , Gastritis/patología , Gastritis Atrófica/metabolismo , Gastritis Atrófica/patología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/metabolismo , Infecciones por Helicobacter/patología , Humanos , Inmunofenotipificación , Ratones , Neoplasias Gástricas/etiología , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patología , Linfocitos T/metabolismo , Linfocitos T/patología

RESUMEN

PURPOSE: There is limited information about the dietary habits associated with stomach adenocarcinoma in the Brazilian population, so our purpose is to analyze the consumption of processed and ultra-processed foods by patients with stomach adenocarcinoma in Brazil. METHODS: A multicentric hospital-based case-control study was conducted in São Paulo (southeastern region) and Belém (Amazon region) of Brazil with 1,045 individuals, both sexes, between 18 and 75 years old. In São Paulo, there were 214 cases with stomach adenocarcinoma and 150 controls patients submitted to stomach endoscopy named as Group I (without any pre-malignant gastric disease) and the Healthy Controls (Group 2) comprised 401 individuals matched by age and sex from the prevention unit at A.C .Camargo Cancer Center. In Belém, it has two groups one are cases 140 and second 140 hospital controls, recruited in outpatient clinics. Lifestyle and food frequency questionnaires (FFQ) were administered in cases and controls in both places. Univariate and multivariable binomial logistic regression analyses were performed. RESULTS: In São Paulo, cases reported two times greater consumption of processed meat (adjusted OR 2.56, 95% CI 1.32-4.96) and of sweets (≥ 80 g/day) than Group 1 (endoscopic controls) (adjusted OR 2.25, 95% CI 1.21-4.18). Compared with Group 2, processed food consumption (≥ 44 g/day) as well as ≥ 44 g/day of salted bread increased the odds of having stomach adenocarcinoma (adjusted OR 2.96, 95% CI 1.82-4.81 and adjusted OR 2.03, 95% CI 1.30-3.18), respectively. In Belém, individuals who reported consuming ≥ 166 g/day of fried and roasted meat and fish were more likely to have stomach adenocarcinoma (adjusted OR 2.21, 95% CI 1.13-4.30). CONCLUSIONS: In both cities, consumption of processed and ultra-processed foods, especially salted bread, yellow cheese, fried and roasted meats, fish fried, processed meat, and sweets, was independently associated with the chance of having stomach adenocarcinoma.

Asunto(s)

Adenocarcinoma , Neoplasias Gástricas , Adenocarcinoma/epidemiología , Adenocarcinoma/etiología , Animales , Brasil/epidemiología , Estudios de Casos y Controles , Dieta/efectos adversos , Conducta Alimentaria , Femenino , Peces , Humanos , Masculino , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología

RESUMEN

INTRODUCTION AND AIMS: Surgery is the main treatment for gastric cancer. D2 radical gastrectomy is associated with a variable postoperative morbidity and mortality rate worldwide. The aim of the present study was to identify the risk factors associated with the postoperative morbidity and mortality of D2 radical gastrectomy, with curative intent, for gastric cancer. MATERIALS AND METHODS: A retrospective case series was conducted, in which the medical records were reviewed of patients with gastric cancer that underwent D2 radical gastrectomy, within the time frame of January 2014 and December 2018. Univariate and multivariate analyses were carried out to identify the risk factors related to postoperative morbidity and mortality within 90 days. RESULTS: The percentages of postoperative morbidity and mortality in 691 patients were 23.3% and 3.3%, respectively. In the multivariate analysis, age ≥70 years (OR = 1.85, 95% CI: 1.25-2.76), ASA III-IV (OR = 2.06, 95% CI: 1.28-3.34), total gastrectomy (OR = 1.96, 95% CI:1.19-3.23), and pancreatosplenectomy (OR = 5.41, 95% CI: 1.42-20.61) were associated with greater postoperative morbidity, and age ≥70 years (OR = 4.92, 95% CI:1.78-13.65), lower BMI (OR = 0.81, 95% CI: 0.71-0.92), and hypoalbuminemia (OR = 0.91, 95% CI: 0.85-0.98) were associated with greater mortality in distal and total D2 radical gastrectomy. CONCLUSIONS: D2 radical gastrectomy for gastric cancer was shown to be a safe treatment, with low postoperative morbidity and mortality rates. Age ≥70 years, ASA III-IV, total gastrectomy, and pancreatosplenectomy were factors associated with a higher complication rate. Age ≥70 years, lower BMI, and hypoalbuminemia were mortality predictors in distal and total radical gastrectomy.

Asunto(s)

Hipoalbuminemia , Neoplasias Gástricas , Anciano , Gastrectomía/efectos adversos , Humanos , Hipoalbuminemia/complicaciones , Hipoalbuminemia/epidemiología , Morbilidad , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Gástricas/etiología , Neoplasias Gástricas/cirugía

RESUMEN

INTRODUCTION: although it is a rare disease, common variable immunodeficiency (CVID) stands out as the most frequent primary symptomatic immunodeficiency. Carriers are prone to a variety of recurrent bacterial infections, in addition to the risk of developing autoimmune diseases and neoplasms including gastric cancer (GC). Despite the recognized risk, there are no specific standardized protocols for the management of GC in these patients, so the reported oncological results are varied. Thus, this study aims to describe the clinicopathological characteristics and prognosis of patients with CVID undergoing surgical treatment of GC. METHODS: all patients with GC undergoing surgical treatment between 2009 and 2020 were retrospectively evaluated. Later, patients diagnosed with CVID were identified and this group was compared with the remaining patients without any immunodeficiency. RESULTS: among the 1101 patients with GC evaluated in the period, 10 had some type of immunodeficiency, and 5 were diagnosed with CVID. Patients with CVID had younger age, lower BMI, and smaller lesions compared to those without CVID. Four patients underwent curative gastrectomy and one patient underwent jejunostomy. Two patients died (1 palliative and 1 curative) and one patient had disease recurrence. There was no statistically significant difference regarding the incidence of postoperative complications and survival between the evaluated groups. CONCLUSION: the CVID incidence in patients with GC undergoing surgical treatment was 0.5%, occurring at a less advanced age, but with no difference regarding surgical and oncological results.

Asunto(s)

Inmunodeficiencia Variable Común , Neoplasias Gástricas , Inmunodeficiencia Variable Común/epidemiología , Humanos , Recurrencia Local de Neoplasia , Estudios Retrospectivos , Factores de Riesgo , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología , Neoplasias Gástricas/cirugía

RESUMEN

Helicobacter pylori is the main etiological agent of all malignant tumors caused by an infectious disease. It is a major, at times dominant, factor in the pathogenesis of a large spectrum of diseases such as acute and chronic gastritis, gastric and duodenal ulcers, gastric carcinoma, and lymphoma. Epidemiological and experimental studies suggest that H. pylori chronic infection may be related to different extragastric diseases, including colorectal neoplasms. This concise review aims to explore the association of H. pylori infection with colorectal cancer and adenoma, including the recent epidemiological findings, the diagnostic methods employed to detect H. pylori and virulent factors, and the potentially involved mechanisms. Furthermore, is attempted to establish the current data integration for causal inference using the Bradford-Hill causality criteria. The weak, although global, strength of the epidemiological positive association between H. pylori infection and colonic neoplasms associated to new mechanisms postulated to explain this interaction, including intestinal dysbiosis, should stimulate future studies. Prospective confirmatory studies to establish the role of H. pylori eradication in the process of carcinogenic transformation of the colonic epithelium may define its eventual role in the treatment and prevention of colonic neoplasms.

Asunto(s)

Neoplasias Colorrectales , Gastritis , Infecciones por Helicobacter , Helicobacter pylori , Neoplasias Gástricas , Neoplasias Colorrectales/epidemiología , Neoplasias Colorrectales/etiología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/epidemiología , Humanos , Estudios Prospectivos , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología

RESUMEN

ABSTRACT Helicobacter pylori is the main etiological agent of all malignant tumors caused by an infectious disease. It is a major, at times dominant, factor in the pathogenesis of a large spectrum of diseases such as acute and chronic gastritis, gastric and duodenal ulcers, gastric carcinoma, and lymphoma. Epidemiological and experimental studies suggest that H. pylori chronic infection may be related to different extragastric diseases, including colorectal neoplasms. This concise review aims to explore the association of H. pylori infection with colorectal cancer and adenoma, including the recent epidemiological findings, the diagnostic methods employed to detect H. pylori and virulent factors, and the potentially involved mechanisms. Furthermore, is attempted to establish the current data integration for causal inference using the Bradford-Hill causality criteria. The weak, although global, strength of the epidemiological positive association between H. pylori infection and colonic neoplasms associated to new mechanisms postulated to explain this interaction, including intestinal dysbiosis, should stimulate future studies. Prospective confirmatory studies to establish the role of H. pylori eradication in the process of carcinogenic transformation of the colonic epithelium may define its eventual role in the treatment and prevention of colonic neoplasms.

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RESUMO Helicobacter pylori é o principal agente etiológico dos tumores malignos causados por doenças infecciosas. Constitui fator importante, às vezes dominante, na patogênese de um amplo espectro de doenças como gastrite aguda e crônica, úlceras gástricas e duodenais, carcinoma gástrico e linfoma. Estudos epidemiológicos e experimentais sugerem que a infecção crônica por H. pylori pode estar relacionada a diferentes doenças extragástricas, incluindo neoplasias colorretais. Esta concisa revisão tem como objetivo explorar a associação da infecção por H. pylori com câncer colorretal e adenoma, incluindo os recentes achados epidemiológicos, os métodos de diagnóstico empregados para detectar H. pylori e seus fatores de virulência com os mecanismos potencialmente envolvidos nesta relação. Além disso, procura-se estabelecer a integração dos dados atuais na busca de inferência causal com o emprego dos critérios de causalidade de Bradford-Hill. A associação epidemiológica positiva entre infecção por H. pylori e neoplasias do cólon embora classificada como fraca - porém global - do ponto de vista epidemiológico, quando associada a mecanismos recentemente postulados para explicar essa interação, incluindo disbiose intestinal, deverá estimular a realização de investigações futuras. Estudos prospectivos confirmatórios para estabelecer o papel da erradicação do H. pylori no processo de transformação carcinogênica do epitélio do cólon são aguardados para definir seu eventual papel no tratamento e prevenção de neoplasias do cólon.

Asunto(s)

Humanos , Neoplasias Gástricas/etiología , Neoplasias Gástricas/epidemiología , Neoplasias Colorrectales/etiología , Neoplasias Colorrectales/epidemiología , Helicobacter pylori , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/epidemiología , Gastritis , Estudios Prospectivos

RESUMEN

Gastric cancer (GC) is the fifth leading cause of cancer deaths in the world, with variations across geographical regions and ethnicities. Emerging evidence indicates that miRNA expression is dysregulated in GC and its polymorphisms may contribute to these variations, which has yet to be explored in Latin American populations. In a case-control study of 310 GC patients and 311 healthy donors from Chile, we assessed the association of 279 polymorphisms in 242 miRNA genes. Two novel polymorphisms were found to be associated with GC: rs4822739:C>G (miR-548j) and rs701213:T>C (miR-4427). Additionally, rs1553867776:T>TCCCCA (miR-4274) and rs12416605:C>T (miR-938) were associated with intestinal-type GC, and rs4822739:C>G (miR-548j) and rs1439619:T>G (miR-3175) with TNM I-II stage. The polymorphisms rs6149511:T> TGAAGGGCTCCA (miR-6891), rs404337:G>A (miR-8084), and rs1439619:T>G (miR-3175) were identified among H.pylori-infected GC patients and rs7500280:T>C (miR-4719) and rs1439619:T>G (miR-3175) were found among H. pylori cagPAI+ infected GC cases. Prediction analysis suggests that seven polymorphisms could alter the secondary structure of the miRNA, and the other one is located in the seed region of miR-938. Targets of miRNAs are enriched in GC pathways, suggesting a possible biological effect. In this study, we identified seven novel associations and replicated one previously described in Caucasian population. These findings contribute to the understanding of miRNA genetic polymorphisms in the GC pathogenesis.

Asunto(s)

Biomarcadores de Tumor/genética , Infecciones por Helicobacter/complicaciones , MicroARNs/genética , Neoplasias Gástricas , Adulto , Estudios de Casos y Controles , Chile/epidemiología , Femenino , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología , Neoplasias Gástricas/genética

RESUMEN

Gastric cancer is the fifth most common cancer worldwide. Investigations of lifestyle factors such as physical activity may identify risk patterns in this population. Thus, the aim of this study was to analyze the level of habitual physical activity and its association with the risk of gastric adenocarcinoma in the Amazon region. We conducted a hospital-based case-control study. Questionnaires investigating sociodemographic characteristics and physical activity were applied between July 2017 and April 2019. To assess habitual physical activity, we used the Baecke Physical Activity Questionnaire, which assessed physical exercise (PE), occupational physical activity, and leisure and locomotion activity (LLA). The Chi-square association test was applied and univariate and multiple binary logistic regression models were used for odds ratio analysis. The descriptive level of 5% (P < 0.05) was selected for statistical significance. The sample consisted of 297 individuals, with 147 cases and 150 controls. Those who performed PE at the second percentile level for 5 years before the interview were 71% less likely to develop gastric cancer (P = 0.012). Individuals with the highest LLA levels during the preceding 10 and 15 years were 76 and 78% less likely to have gastric cancer, respectively. In this study, physical activity related to sport and to leisure and locomotion was an independent protective factor that was inversely associated with gastric cancer.

Asunto(s)

Neoplasias Gástricas , Brasil/epidemiología , Estudios de Casos y Controles , Ejercicio Físico , Humanos , Actividades Recreativas , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/etiología , Neoplasias Gástricas/prevención & control , Encuestas y Cuestionarios

RESUMEN

BACKGROUND: Regional variations in gastric cancer incidence are not explained by prevalence of Helicobacter pylori, the main cause of the disease, with several areas presenting high H. pylori prevalence but low gastric cancer incidence. The IARC worldwide H. pylori prevalence surveys (ENIGMA) aim at systematically describing age and sex-specific prevalence of H. pylori infection around the world and generating hypotheses to explain regional variations in gastric cancer risk. METHODS: We selected age- and sex-stratified population samples in two areas with different gastric cancer incidence and mortality in Chile: Antofagasta (lower rate) and Valdivia (higher rate). Participants were 1-69 years old and provided interviews and blood for anti-H. pylori antibodies (IgG, VacA, CagA, others) and atrophy biomarkers (pepsinogens). RESULTS: H. pylori seroprevalence (Age-standardized to world population) and antibodies against CagA and VacA were similar in both sites. H. pylori seroprevalence was 20% among children <10 years old, 40% among 10-19 year olds, 60% in the 20-29 year olds and close to or above 80% in those 30+ years. The comparison of the prevalence of known and potential H. pylori cofactors in gastric carcinogenesis between the high and the low risk area showed that consumption of chili products was significantly higher in Valdivia and daily non-green vegetable consumption was more common in Antofagasta. Pepsinogen levels suggestive of gastric atrophy were significantly more common and occurred at earlier ages in Valdivia, the higher risk area. In a multivariate model combining both study sites, age, chili consumption and CagA were the main risk factors for gastric atrophy. CONCLUSIONS: The prevalence of H. pylori infection and its virulence factors was similar in the high and the low risk area, but atrophy was more common and occurred at younger ages in the higher risk area. Dietary factors could partly explain higher rates of atrophy and gastric cancer in Valdivia. IMPACT: The ENIGMA study in Chile contributes to better understanding regional variations in gastric cancer incidence and provides essential information for public health interventions.

Asunto(s)

Infecciones por Helicobacter/complicaciones , Helicobacter pylori/aislamiento & purificación , Neoplasias Gástricas/etiología , Estómago/patología , Adolescente , Adulto , Anciano , Atrofia/etiología , Atrofia/microbiología , Atrofia/patología , Niño , Preescolar , Chile/epidemiología , Femenino , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Estómago/microbiología , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patología , Adulto Joven

RESUMEN

Helicobacter pylori is a Gram-negative bacterium that causes chronic atrophic gastritis and peptic ulcers and it has been associated with the development of gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT). One of the more remarkable characteristics of H. pylori is its ability to survive in the hostile environment of the stomach. H. pylori regulates the expression of specific sets of genes allowing it to survive high acidity levels and nutrient scarcity. In the present study, we determined the expression of virulence associated protein D (VapD) of H. pylori inside adenocarcinoma gastric (AGS) cells and in gastric biopsies. Using qRT-PCR, VapD expression was quantified in intracellular H. pylori-AGS cell cultures at different time points and in gastric mucosa biopsies from patients suffering from chronic atrophic gastritis, follicular gastritis, peptic ulcers, gastritis precancerous intestinal metaplasia and adenocarcinoma. Our results show that vapD of H. pylori presented high transcription levels inside AGS cells, which increased up to two-fold above basal values across all assays over time. Inside AGS cells, H. pylori acquired a coccoid form that is metabolically active in expressing VapD as a protection mechanism, thereby maintaining its permanence in a viable non-cultivable state. VapD of H. pylori was expressed in all gastric biopsies, however, higher expression levels (p = 0.029) were observed in gastric antrum biopsies from patients with follicular gastritis. The highest VapD expression levels were found in both antrum and corpus gastric biopsies from older patients (>57 years old). We observed that VapD in H. pylori is a protein that is only produced in response to interactions with eukaryotic cells. Our results suggest that VapD contributes to the persistence of H. pylori inside the gastric epithelial cells, protecting the microorganism from the intracellular environment, reducing its growth rate, enabling long-term infection and treatment resistance.

Asunto(s)

Proteínas Bacterianas/genética , Gastritis Atrófica/etiología , Helicobacter pylori/genética , Glicoproteínas de Membrana/genética , Estómago/microbiología , Estómago/patología , Adenocarcinoma/etiología , Adenocarcinoma/microbiología , Adenocarcinoma/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Técnicas de Cocultivo/métodos , Femenino , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Gastritis Atrófica/microbiología , Gastritis Atrófica/patología , Gastroscopía/métodos , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/patología , Humanos , Intestinos/microbiología , Intestinos/patología , Masculino , Metaplasia/microbiología , Metaplasia/patología , Persona de Mediana Edad , Úlcera Péptica/metabolismo , Úlcera Péptica/patología , Lesiones Precancerosas/etiología , Lesiones Precancerosas/microbiología , Lesiones Precancerosas/patología , Antro Pilórico/microbiología , Antro Pilórico/patología , Neoplasias Gástricas/etiología , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patología , Virulencia/genética , Adulto Joven

RESUMEN

BACKGROUND: Geospatial technology has facilitated the discovery of disease distributions and etiology and helped target prevention programs. Globally, gastric cancer is the leading infection-associated cancer, and third leading cause of cancer mortality worldwide, with marked geographic variation. Central and South America have a significant burden, particularly in the mountainous regions. In the context of an ongoing population-based case-control study in Central America, our aim was to examine the spatial epidemiology of gastric cancer subtypes and H. pylori virulence factors. METHODS: Patients diagnosed with gastric cancer from 2002 to 2013 in western Honduras were identified in the prospective gastric cancer registry at the principal district hospital. Diagnosis was based on endoscopy and confirmatory histopathology. Geospatial methods were applied using the ArcGIS v10.3.1 and SaTScan v9.4.2 platforms to examine regional distributions of the gastric cancer histologic subtypes (Lauren classification), and the H. pylori CagA virulence factor. Getis-Ord-Gi hot spot and Discrete Poisson SaTScan statistics, respectively, were used to explore spatial clustering at the village level (30-50 rural households), with standardization by each village's population. H. pylori and CagA serologic status was determined using the novel H. pylori multiplex assay (DKFZ, Germany). RESULTS: Three hundred seventy-eight incident cases met the inclusion criteria (mean age 63.7, male 66.3%). Areas of higher gastric cancer incidence were identified. Significant spatial clustering of diffuse histology adenocarcinoma was revealed both by the Getis-Ord-GI* hot spot analysis (P-value < 0.0015; range 0.00003-0.0014; 99%CI), and by the SaTScan statistic (P-value < 0.006; range 0.0026-0.0054). The intestinal subtype was randomly distributed. H. pylori CagA had significant spatial clustering only in association with the diffuse histology cancer hot spot (Getis-Ord-Gi* P value ≤0.001; range 0.0001-0.0010; SaTScan statistic P value 0.0085). In the diffuse gastric cancer hot spot, the lowest age quartile range was 21-46 years, significantly lower than the intestinal cancers (P = 0.024). CONCLUSIONS: Geospatial methods have identified a significant cluster of incident diffuse type adenocarcinoma cases in rural Central America, suggest of a germline genetic association. Further genomic and geospatial analyses to identify potential spatial patterns of genetic, bacterial, and environmental risk factors may be informative.

Asunto(s)

Salud Rural , Neoplasias Gástricas/epidemiología , Anciano , Estudios de Casos y Controles , América Central/epidemiología , Susceptibilidad a Enfermedades , Femenino , Geografía , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/microbiología , Helicobacter pylori , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Análisis Espacial , Neoplasias Gástricas/etiología , Neoplasias Gástricas/patología

RESUMEN

Helicobacter pylori (H. pylori) is a cosmopolite bacteria and the main responsible for the high burden of gastric cancer in developing countries, such as Peru. In this review, we describe some historical facts in the H. Pylori discovery, the first researches of this bacterium in Peru, as well as its epidemiology, clinical characteristics, diagnosis, treatments, and outcomes. Our literature and review of real-life data suggest that several efforts should be conducted in our country to deal with antibiotic-resistance and lack of adherence to treatment in order to reduce our incidence of gastric cancer.

Asunto(s)

Infecciones por Helicobacter/historia , Helicobacter pylori/aislamiento & purificación , Neoplasias Gástricas/epidemiología , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/virología , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Incidencia , Perú/epidemiología , Neoplasias Gástricas/etiología , Neoplasias Gástricas/prevención & control

RESUMEN

Histone modifications regulate the structural status of chromatin and thereby influence the transcriptional status of genes. These processes are controlled by the recruitment of different enzymes to a specific genomic site. Furthermore, obtaining an understanding of these mechanisms could help delineate alternative treatment and preventive strategies for cancer. For example, in gastric cancer, cholecalciferol, curcumin, resveratrol, quercetin, garcinol and sodium butyrate are natural regulators of acetylation and deacetylation enzyme activity that exert chemopreventive and anticancer effects. Here, we review the recent findings on histone acetylation in gastric cancer and discuss the effects of nutrients and bioactive compounds on histone acetylation and their potential role in the prevention and treatment of this type of cancer.

Asunto(s)

Susceptibilidad a Enfermedades , Histonas/metabolismo , Neoplasias Gástricas/etiología , Neoplasias Gástricas/metabolismo , Acetilación/efectos de los fármacos , Animales , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Dietética , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Inhibidores de Histona Desacetilasas/farmacología , Inhibidores de Histona Desacetilasas/uso terapéutico , Humanos , Procesamiento Proteico-Postraduccional , Neoplasias Gástricas/patología , Neoplasias Gástricas/terapia

RESUMEN

BACKGROUND: Although, outer membrane protein OipA of Helicobacter pylori has been associated with gastric mucosal damage and gastroduodenal diseases, studies evaluating gastric cancer patients are scarce. We investigated whether the functional oipA "on" status was associated with gastric cancer in the North-eastern Brazil, region with high prevalence of gastric cancer. METHODS: We included samples from 95 H. pylori positive subjects (23 patients with gastritis, 24 with gastric cancer, 32 first-degree relatives of gastric cancer patients and 16 children). oipA was assayed by polymerase chain reaction (PCR) and DNA sequencing. cagA and vacA status were evaluated by PCR. RESULTS: Overall 81.1% of the H. pylori strains had functional oipA. In adults, the oipA "on" status (OR = 9.20; 95%CI = 1.45-58.48, P = 0.02) and increasing age (OR = 1.08; 95%CI = 1.03-1.14; P = 0.003) were independently associated with gastric cancer in a logistic model. The oipA "on" status (OR = 14.75; 95%CI: 2.53-86.13, P = 0.003) was also associated with first-degree relatives of gastric cancer patients when compared with gastritis. The frequency of oipA "on" status did not differ between children and adults (P = 0.87). The oipA "on" status was significantly correlated with the presence of cagA and vacA s1 m1. CONCLUSION: oipA "on" status was independently associated with gastric cancer and first-degree relatives of gastric cancer patients in North-eastern Brazil.

Asunto(s)

Proteínas Bacterianas/genética , Infecciones por Helicobacter/complicaciones , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Neoplasias Gástricas/etiología , Brasil/epidemiología , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Masculino , Sistemas de Lectura Abierta , Prevalencia

RESUMEN

INTRODUCTION AND OBJECTIVE: Follicular gastritis is associated with Helicobacter pylori infection, but little is known of its relation to bacterial genotypes. Our aim was to establish the relation between follicular gastritis and different H. pylori strains. MATERIALS AND METHODS: An analytic case-control study was conducted that included 36 patients with follicular gastritis (cases) and 83 with nonatrophic gastritis (controls). The sociodemographic information was obtained through a questionnaire. Biopsies were evaluated according to the Sydney System and the Wotherspoon scoring system. Helicobacter pylori genotyping was performed using the polymerase chain reaction technique. The quantitative variables were presented as mean and standard deviation and the qualitative variables as proportions and absolute frequency. The effect of each variable on outcome (follicular gastritis) was evaluated through the odds ratio and its 95% confidence interval. Statistical significance was set at a P<0.05. RESULTS: Follicular gastritis was associated with Helicobacter pylori infection (OR: 13.41, CI: 1.7-103, P=0.01). The CagA+ genotype was present in 56.5% of the cases and 58% of the controls. The cytotoxic VacAs1m1strain was present in 82% of the isolates in both groups. IceA1 frequency was 34.8% in the cases and 26% in the controls and the difference was not statistically significant. CONCLUSIONS: The population studied had elevated frequencies of cytotoxic Helicobacter pylori strains and the iceA1 genotype was more frequent in follicular gastritis.

Asunto(s)

Gastritis/microbiología , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Neoplasias Gástricas/microbiología , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Estudios de Casos y Controles , Enfermedad Crónica , Colombia , Femenino , Gastritis/etiología , Genotipo , Infecciones por Helicobacter/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Reacción en Cadena de la Polimerasa , Riesgo , Factores Socioeconómicos , Neoplasias Gástricas/etiología , Adulto Joven