TY - JOUR
T1 - Helicobacter pylori and progressive gastric pathology that predisposes to gastric cancer
AU - Recavarren-Arce, S.
AU - León-Barúa, R.
AU - Cok, J.
AU - Berendson, R.
AU - Gilman, R. H.
AU - Ramírez-Ramos, A.
AU - Rodríguez, C.
AU - Spira, W. M.
N1 - Funding Information:
This study was partially supported by grants NIH DK39048-02 and USAID (PSTC) 8.15.
PY - 1991
Y1 - 1991
N2 - Recavarren-Arce S, León-Barúa R, Cok J, Berendson R, Gilman RH, Ramírez-Ramos A, Rodríguez C, Spira WM. Helicobacter pylori and progressive gastric pathology that predisposes to gastric cancer. Scand J Gastroenterol 1991, 26(suppl 181), 51-57 Evidence is presented suggesting that infection by Helicobacter pylori triggers and continuously contributes to the pathophysiology of progressive gastric changes that can ultimately lead to gastric cancer. In Peru, especially in population groups of low socioeconomic status, infection by H. pylori begins earlier in life and is more prevalent and persistent than in developed countries. The infection produces a destructive lesion of the mucinous surface epithelium which probably enables other aggressive luminal factors to cause further mucosal damage. As a consequence, active chronic gastritis appears. The gastritis is of the superficial type at the beginning but may progressively change to atrophic. Chronic atrophic gastritis is found more frequently and at a younger age in dyspeptic patients with low socioeconomic status-that is, in patients having higher prevalence of persistent infection by H. pylori since earlier in life. When chronic atrophic gastritis becomes severe and extensive, hypochlorhydria ensues. Hypochlorhydria favors the appearance of bacterial overgrowth, nitrites, and N-nitroso compounds in the gastric lumen. N-nitroso compounds, because of their mutagenic-carcinogenic properties, probably induce gastric premalignant lesions like intestinal metaplasia and dysplasia of the gastric mucosa. Oral bismuth therapy apparently reverses H. pylori-associated gastric dysplasia. It is proposed that future programs designed for the control of gastric cancer would be incomplete if they do not include further evaluation of the many effects of infection by H. pylori on the gastric mucosa and of cost-effective methods to eradicate the infection.
AB - Recavarren-Arce S, León-Barúa R, Cok J, Berendson R, Gilman RH, Ramírez-Ramos A, Rodríguez C, Spira WM. Helicobacter pylori and progressive gastric pathology that predisposes to gastric cancer. Scand J Gastroenterol 1991, 26(suppl 181), 51-57 Evidence is presented suggesting that infection by Helicobacter pylori triggers and continuously contributes to the pathophysiology of progressive gastric changes that can ultimately lead to gastric cancer. In Peru, especially in population groups of low socioeconomic status, infection by H. pylori begins earlier in life and is more prevalent and persistent than in developed countries. The infection produces a destructive lesion of the mucinous surface epithelium which probably enables other aggressive luminal factors to cause further mucosal damage. As a consequence, active chronic gastritis appears. The gastritis is of the superficial type at the beginning but may progressively change to atrophic. Chronic atrophic gastritis is found more frequently and at a younger age in dyspeptic patients with low socioeconomic status-that is, in patients having higher prevalence of persistent infection by H. pylori since earlier in life. When chronic atrophic gastritis becomes severe and extensive, hypochlorhydria ensues. Hypochlorhydria favors the appearance of bacterial overgrowth, nitrites, and N-nitroso compounds in the gastric lumen. N-nitroso compounds, because of their mutagenic-carcinogenic properties, probably induce gastric premalignant lesions like intestinal metaplasia and dysplasia of the gastric mucosa. Oral bismuth therapy apparently reverses H. pylori-associated gastric dysplasia. It is proposed that future programs designed for the control of gastric cancer would be incomplete if they do not include further evaluation of the many effects of infection by H. pylori on the gastric mucosa and of cost-effective methods to eradicate the infection.
KW - Chronic gastritis
KW - Helicobacter pylori
KW - Hypochlorhydria
KW - N-nitrosocom-pounds
KW - Oral bismuth
KW - Precancerous lesions
UR - http://www.scopus.com/inward/record.url?scp=0025802921&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0025802921&partnerID=8YFLogxK
U2 - 10.3109/00365529109093208
DO - 10.3109/00365529109093208
M3 - Article
C2 - 1866595
AN - SCOPUS:0025802921
SN - 0036-5521
VL - 26
SP - 51
EP - 57
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - S181
ER -