Diagnóstico precoz de cáncer gástrico: Propuesta de detección y seguimiento de lesiones premalignas gástricas: protocolo ACHED

• Antonio Rollán ^[1] ; Pablo Cortés ^[1] ; Alfonso Calvo ^[7] ; Raúl Araya ^[8] ; María Ester Bufadel ^[2] ; Robinson González ^[3] ; Carolina Heredia ^[9] ; Pablo Muñoz ^[2] ; Freddy Squella ^[10] ; Roberto Nazal ^[11] ; María de los Ángeles Gatica ^[1] ; Jaquelina Gobelet ^[1] ; René Estay ^[4] ; Raúl Pisano ^[5] ; Luis Contreras ^[12] ; Ingrid Osorio ^[13] ; Ricardo Estela ^[14] ; Fernando Fluxá ^[6] ; Adolfo Parra-Blanco ^[3]
  1. [1] Clínica Alemana

     Clínica Alemana

     Santiago, Chile

     
  2. [2] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  3. [3] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
  4. [4] Clinica Santa Maria

     Clinica Santa Maria

     Santiago, Chile

     
  5. [5] Hospital San Juan de Dios

     Hospital San Juan de Dios

     Santiago, Chile

     
  6. [6] Clínica Las Condes

     Clínica Las Condes

     Santiago, Chile

     
  7. [7] CRS San Rafael Unidad de Endoscopia
  8. [8] Hospital Militar Unidad de Gastroenterología y Servicio de Endoscopia
  9. [9] Hospital Militar Servicio de Endoscopia
  10. [10] Clínica Indisa Servicio de Gastroenterología
  11. [11] Hospital San José
  12. [12] Laboratorio de Anatomía Patológica C y S
  13. [13] Hospital El Pino
  14. [14] Instituto Chileno-Japonés de Enfermedades Digestivas

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 142, Nº. 9, 2014, págs. 1181-1192
• Idioma: español
• Títulos paralelos:
  • Recommendations of the Chilean association for digestive endoscopy for the management of gastric pre-malignant lesions
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  • Texto completo
• Resumen

  • An expert panel analyzed the available evidence and reached a consensus to release 24 recommendations for primary and secondary prevention of gastric cancer (CG) in symptomatic patients, with indication for upper GI endoscopy. The main recommendations include (1) Search for and eradicate H. pylori infection in all cases. (2) Systematic gastric biopsies (Sydney protocol) in all patients over 40 years of age or first grade relatives of patient with CG, to detect gastric atrophy, intestinal metaplasia or dysplasia. (3) Incorporate the OLGA system (Operative Link on Gastritis Assessment) to the pathological report, to categorize the individual risk of CG. (4) Schedule endoscopic follow-up according to the estimated risk of CG, namely annual for OLGA III- IV, every 3 years for OLGA I- II or persistent H. pylori infection, every 5 years for CG relatives without other risk factors and no follow-up for OLGA 0, H. pylori (-). (4) Establish basic human and material resources for endoscopic follow-up programs, including some essential administrative processes, and (5) Suggest the early CG/total CG diagnosis ratio of each institution and the proportion of systematic recording of endoscopic images, as quality indicators. These measures are applicable using currently available resources, they can complement any future screening programs for asymptomatic population and may contribute to improve the prognosis of CG in high-risk populations.