Liječnički vjesnik, Vol. 136 No. 3-4, 2014.
Stručni rad
CROATIAN GUIDELINES FOR GASTRIC CANCER PREVENTION BY ERADICATION OF HELICOBACTER PYLORI INFECTION
Miroslava Katičić
Marko Banić
Marija Crnčević Urek
Slavko Gašparov
Željko Krznarić
Marija Prskalo
Davor Štimac
Anita Škrtić
Boris Vucelić
Sažetak
Gastric cancer is the fourth most common type of cancer and the second leading cause of cancer-related death in the world. Although gastric cancer has a multifactorial etiology, infection with Helicobacter pyloriis highly associated with gastric carcinogenesis. Carcinogenesis is also influenced by some environmental factors and host genetic diversity, which engenders differential host inflammatory responses that can influence clinical outcome. Chronic gastritis induced by H. pylori is the strongest known risk factor for adenocarcinoma of the distal stomach, but the effects of bacterial eradication on carcinogenesis have remained unclear up to now. Although eradication of H. pylori infection appears to reduce the risk of gastric cancer, several recent controlled interventional trials by H. pylori eradication to prevent gastric cancer have yielded disappointing results. To clarify this problem in a high-risk population, the investigators conducted a prospective, randomized, double-blind, placebo-controlled, population-based studies. The results of previous studies highlight the importance of longer and careful follow-up after eradication therapy. It seems that eradication treatment is effective in preventing gastric cancer if it is given before preneoplastic conditions/lesions, gastric atrophy, metaplasia, and dysplasia, have had time to develop. Furthermore, the significant efficacy of treatment observed in younger patients suggests the need to eradicate H. pylori as early as possible. This consensus aimed to propose guidelines for the diagnosis, management and control of individuals with chronic gastritis, atrophy, intestinal metaplasia, or dysplasia.
Ključne riječi
Stomach neoplasms – microbiology, pathology, prevention and control; Helicobacter infections – epidemiology, complications, drug therapy; Helicobacter pylori – pathogenicity, drug effects; Gastritis – microbiology, pathology; Metaplasia – microbiology, pathology, prevention and control; Precancerous conditions – microbiology, pathology, prevention and control; Disease eradication; Algorithms; Croatia
Hrčak ID:
172589
URI
Datum izdavanja:
30.4.2014.
Posjeta: 1.755 *