Helicobacter pylori en metaplasia intestinal gástrica implementación de protocolo
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Se realizó un estudio y un protocolo de implementación para el manejo de biopsias gástricas, a partir de una selección de casos con diagnóstico de metaplasia intestinal gástrica, debido a su alta susceptibilidad a formar cáncer, como su principal factor de riesgo el bacilo de Helicobacter pylori, en el hospital oncológico Dr. Juan Tanca Marengo SOLCA, de Guayaquil. Para realizar el estudio se tomaron datos de 64 pacientes que tuvieron como diagnostico metaplasia intestinal gástrica, en el periodo 2014, obteniéndose la información de las historias clínicas de nuestra institución., todas las muestras fueron manejadas por técnicas convencionales, incluyendo el procesamiento de tejido con tinción de Hematoxilina y Eosina.
Los resultados mostraron que los pacientes con metaplasia intestinal gástrica, tienen mayor incidencia en las edades comprendidas entre 60 a 70 años, con predilección en frecuencia la metaplasia intestinal tipo incompleta 49 %, con afectación mayoritaria al sexo femenino 2/1, las edades más frecuentes en asociación con el H pylori se encuentran entre 50 a 60 años, en relación a la presencia de lesiones premalignas como las displasias glandulares tanto leve a severa. Por tal motivo el H. pylori se considera más como un factor de riesgo, y no un agente etiológico del cáncer gástrico, esto a su vez asociado a metaplasia intestinal determina mayor riesgo en el desarrollo de neoplasias malignas. La propuesta del protocolo de implementación tiene la finalidad el mejorar la visualización del bacilo del H pylori, con el uso de técnicas de tinción histoquímica “azul de toluidina”, aumentando la sensibilidad en el diagnóstico.
A study and an implementation protocol for the management of gastric biopsy was performed from a selection of cases diagnosed with gastric intestinal metaplasia, due to their high susceptibility to form cancer, as their main risk factor bacillus Helicobacter pylori in the oncological hospital SOLCA Dr. Juan Tanca Marengo, Guayaquil. To conduct the study data of 64 patients who had as diagnosis metaplasia gastric intestinal, in the period 2014 to obtain information from the medical records of our institution were taken. All samples were handled by conventional techniques, including tissue processing with staining hematoxylin and eosin. The results showed that patients with gastric intestinal metaplasia, have a higher incidence in those aged between 60 to 70 years, with predilection often incomplete intestinal metaplasia type 49%, with majority involvement 2/1 female sex, the most frequent age in association with H pylori they are between 50 to 60 years, in relation to the presence of premalignant lesions as both mild to severe dysplasias glandular. Therefore H. pylori is considered more as a risk factor, not a causative agent of gastric cancer, this in turn determines intestinal metaplasia associated with increased risk in the development of malignancies. The proposed protocol implementation aims at improving the display of H pylori bacillus, using histochemical staining techniques "toluidine blue", increasing sensitivity in diagnosis.
A study and an implementation protocol for the management of gastric biopsy was performed from a selection of cases diagnosed with gastric intestinal metaplasia, due to their high susceptibility to form cancer, as their main risk factor bacillus Helicobacter pylori in the oncological hospital SOLCA Dr. Juan Tanca Marengo, Guayaquil. To conduct the study data of 64 patients who had as diagnosis metaplasia gastric intestinal, in the period 2014 to obtain information from the medical records of our institution were taken. All samples were handled by conventional techniques, including tissue processing with staining hematoxylin and eosin. The results showed that patients with gastric intestinal metaplasia, have a higher incidence in those aged between 60 to 70 years, with predilection often incomplete intestinal metaplasia type 49%, with majority involvement 2/1 female sex, the most frequent age in association with H pylori they are between 50 to 60 years, in relation to the presence of premalignant lesions as both mild to severe dysplasias glandular. Therefore H. pylori is considered more as a risk factor, not a causative agent of gastric cancer, this in turn determines intestinal metaplasia associated with increased risk in the development of malignancies. The proposed protocol implementation aims at improving the display of H pylori bacillus, using histochemical staining techniques "toluidine blue", increasing sensitivity in diagnosis.
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Metaplasia intestinal gástrica, Helicobacter pylori, Endoscopía, Hospital SOLCA de Guayaquil, Cantón Guayaquil, Ecuador, Protocolos