Cáncer gástrico temprano vs avanzado: ¿existen diferencias?
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Universidad Industrial de Santander
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Introducción: El cáncer gástrico en Colombia es una enfermedad de alta prevalencia y mortalidad. Es importante detectarlo en estadios tempranos, mediante endoscopia digestiva alta (EDA). Objetivos: Describir las características demográficas, clínicas y endoscópicas de una cohorte de pacientes en un hospital de tercer nivel de Bogotá con cáncer gástrico temprano (CGT) o cáncer gástrico avanzado (CGA) para establecer características que permitan definir enfoque clínico y endoscópico. Materiales y Métodos: Se recolectaron pacientes desde julio de 2005 hasta diciembre de 2013 para un total de 302; se valoraron reportes endoscópicos e historias clínicas. Las variables cualitativas se expresaron con proporciones y las cuantitativas con promedios. Se realizó un análisis de Ji cuadrado y pruebas paramétricas (T de student). Resultados: De 65 pacientes, el 50% es superior y menos del 5 % de los pacientes con cáncer gástrico se detectan en estado temprano. Los datos difieren de los reportado por Jap y colaboradores, quienes tuvieron el diagnóstico de CGT (edad promedio 63 años) y 237 CGA (edad 52 años). En nuestra cohorte, CGT fue más frecuente en mujeres 51% mientras CGA lo fue en hombres 63% y las lesiones tempranas fueron más comunes en pacientes con síntomas dispépticos (52%). En CGA se encontró con más frecuencia signos de alarma, pero no hubo diferencia en la localización de los tumores. La clasificación endoscópica de Paris para las lesiones tempranas fue: 23% I, 32% IIa, 6% IIb, 31% IIc y 8% III. Conclusiones: El CGT es más frecuente en mujeres y el promedio de edad es mayor, lo cual puede estar relacionado en que los pacientes con cáncer difuso son más jóvenes. Los síntomas de alarma son buenos indicadores para un diagnóstico temprano. La evaluación endoscópica debe hacerse de acuerdo al mejor método sistemático disponible en la institución.
Introduction: Gastric cancer in Colombia is a disease of high prevalence and mortality. Is very important detect this neoplasm in early stages through upper endoscopy. Objectives: To describe demographical, clinical and endoscopic characteristics of a cohort from a third level hospital in Bogota –Colombia- with advanced gastric cancer (AGC) or early gastric cancer (EGC) to establish characteristics that allow defining a clinical and endoscopic . Materials and methods: 302 patients were collected from July of 2005 to December of 2013. Endoscopic reports and clinical histories were evaluated. Qualitative variables were expressed with proportions and continuous variables with means. Statistical analysis was performed through chi square test and parametric test (T student). Results: 65 patients had the diagnosis of EGC (mean age: 63 years) and 237 AGC (mean age: 52 years). EGC more often in women 51% as AGC was in men with 63%. Early lesions were commonly found in patients with dyspeptic symptoms (52%). Besides, in AGC were found more frequently warning signs. There were no differences in the localization of tumors. Paris endoscopy classification found in early lesions was: 23% I, 32% IIa, 6% 31% IIc y 8% III. Conclusions: EGC is more common in women and the average age is higher this may be related with diffuse cancer patients being younger. Warning symptoms are good indicators for early diagnosis. Endoscopic evaluation should be done according to systematic methods available in institutions.
Introduction: Gastric cancer in Colombia is a disease of high prevalence and mortality. Is very important detect this neoplasm in early stages through upper endoscopy. Objectives: To describe demographical, clinical and endoscopic characteristics of a cohort from a third level hospital in Bogota –Colombia- with advanced gastric cancer (AGC) or early gastric cancer (EGC) to establish characteristics that allow defining a clinical and endoscopic . Materials and methods: 302 patients were collected from July of 2005 to December of 2013. Endoscopic reports and clinical histories were evaluated. Qualitative variables were expressed with proportions and continuous variables with means. Statistical analysis was performed through chi square test and parametric test (T student). Results: 65 patients had the diagnosis of EGC (mean age: 63 years) and 237 AGC (mean age: 52 years). EGC more often in women 51% as AGC was in men with 63%. Early lesions were commonly found in patients with dyspeptic symptoms (52%). Besides, in AGC were found more frequently warning signs. There were no differences in the localization of tumors. Paris endoscopy classification found in early lesions was: 23% I, 32% IIa, 6% 31% IIc y 8% III. Conclusions: EGC is more common in women and the average age is higher this may be related with diffuse cancer patients being younger. Warning symptoms are good indicators for early diagnosis. Endoscopic evaluation should be done according to systematic methods available in institutions.
Keywords
Stomach Neoplasms, dyspepsia, Endoscopy Digestive System, Alarm, Neoplasias Gástricas, dispepsia, Endoscopía del Sistema Digestivo, Alarma