Cancro gastrico e Helicobacter pylori

Gastric cancer is a common cancer, the fifth cause of death from neoplasm, even though the trend is decreasing. Helicobacter pylori is an etiologic agent, responsible for the beginning of gastric inflammatory cascade, the first step toward cancer. Although this cancer is strongly associated with other environmental factors, such as salt, nitrite and low assumption of fresh fruit and vegetables, the infection by Helicobacter pylori is so important that in 1994 the IARC classified this bacterium as a first class cancerogenic agent. The eradication of Helicobacter pylori drastically reduces cancer risk, preventing the progression from chronic gastritis to metaplasia and probable dysplasia. Gastric biopsy is the gold standard for the gastritis diagnosis, but many indirect markers are proposed to avoid endoscopy or to improve its diagnostic efficacy. Besides serologic testing for antibodies anti Helicobacter pylori, could be helpful the measurement of serum pepsinogens and gastrina. The use of multiple tests allows the grading of atrophic gastritis and also the localization of lesions in the stomach.