Interní Med. 2001; 3(8): 367-368

Infekce Helicobacter pylori a karcinom žaludku

prof. MUDr. Petr Dítě DrSc
III. interní klinika gastroenterologická, FN Brno-Bohunice

Keywords: Helicobacter pylori, strain´s pathogenity, gastric cancer.

Published: December 31, 2001  Show citation

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Dítě P. Infekce Helicobacter pylori a karcinom žaludku. Interní Med. 2001;3(8):367-368.

Incidence žaludečního karcinomu ve světě vykazuje mírný, ale zřetelný pokles. Přesto karcinom žaludku patří mezi zvláště závažné lokalizace maligních nádorů. Alarmující je skutečnost, že v posledních letech došlo ke změně lokalizace v žaludku, významně přibývá karcinomu lokalizovaných na přechodu jícnu v žaludeční tělo.

Helicobacter pylori je velice frekventně nalézán u osob s žaludečním karcinomem a nádorem lymfatické tkáně, MALTOMEM.

Při vývoji malignit u osob H. pylori pozitivních hraje nepochybně významnou roli celá řada dalších faktorů, m. j. i doba trvání, po kterou byl nemocný jedinec infikován bakterií. Zvláště častým je uváděn vztah toxiny obsahujících kmenů H. pylori (obsahují např. CagA, VacA) a nádorů žaludku.

Zásadní otázkou ovšem je, zda eradikací H. pylori kmenů lze dosáhnout snížení incidence karcinomu a zda tedy eradikace má prevelentní efekt.

Některé studie prokazují regresi u osob s MALT-lymfomy po úspěšné eradikaci H. pylori.

K definitivní odpovědi je ovšem třeba dalších, prospektivních a dlouhodobých studií.

HELICOBACTER PYLORI INFECTION AND GASTRIC CANCER

The world´s incidence of gastric cancer, including the Czech Republic, decreased during the last few years. Infection of Helicobacter pylori is very frequently connected with gastric cancer and with lymphoid tissue lymphoma MALT lymphoma.

From prospective cohort studies of diseases connected with infection of H. pylori and gastric cancer is well known, that very inportant factor is the interval between diagnosis of seropositivity H. pylori and the disease.

H. pylori strains with pozitivity of cytotoxins, as is CagA or VacA are frequently found in patients with gastric cancer or MALT lymphoma.

Crucial question is the prevention of gastric cancer with H. pylori eradication. Till now there do not exists studies demonstrated clearly the effect of eradication and decrease of incidence gastric cancer.

In some was tudies demonstrated the effect of eradication H. pylori in patients with MALT lymphoma demonstrated.

Definitive answer needs still other long-term prospective studies.

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