Abstract

GOMEZ ZULETA, Martín; GARZON NOSSA, Diana  and  OTERO R, William. First-degree relatives of patients with gastric cancer have high frequencies of achlorhydria and premalignant gastric lesions. Rev Col Gastroenterol [online]. 2014, vol.29, n.1, pp.3-10. ISSN 0120-9957.

Objective: The objective of this study was to establish the frequency of preconditions for gastric cancer including atrophy, metaplasia, dysplasia and achlorhydria (pH > 5) in first degree relatives of patients with gastric cancer (FDR-GC). Design: This is a prospective case-control study with incidental cases. Patients: One hundred twelve first degree relatives of gastric cancer patients (case group) were paired by age and gender to 117 patients with functional dyspepsia but without GC family history (control group). Study location: This study was conducted in the gastroenterology service of a level three hospital in Bogotá, from March 1st, 2011 to March 31st, 2012. Procedures conducted: High digestive endoscopy, gastric pH measurements and gastric biopsies were performed. Measurements: We evaluated and compared endoscopic and pathological measurements as well as measurement of gastric pH. Results: The case group’s 60 % frequency of pangastritis was higher than the control group’s 28.8% (OR 3.32, CI 1.92 to 5.74, p < 0.05). There were findings suggestive of atrophy in 19.6% of the case group patients and in 7.7 % of the control group (OR 2.65, CI 1.16 to 6. 04, p < 0.05), findings suggestive of intestinal metaplasia in 12.5% of the case group and 0% of the control group, alkaline pH in 35.7 % of the case group and 7 % of the control group (OR 5.94, CI 2.72 to 12.98, p < 0.05). There were 4 cases of low grade dysplasia, two cases of high grade dysplasia (P <0.005), and two of early GC (NS). Conclusions: FDR-GCs had more achlorhydria, premalignant conditions, dysplasia and GC than control patients. The measurement of gastric pH is sensitive for detecting gastric atrophy. FDR-GC patients should be routinely screened with endoscopy and gastric pH measurement

Keywords : Gastric cancer; relatives; atrophy; metaplasia.

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