Acta Médica Colombiana

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Vol 37 # 2
Vol 37 # 2
VOL. 37 No 2 - 2012-05-01

Trabajos originales / Original works
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VOL. 37 No 2 - 2012-05-01

Diferenciacin de cncer gstrico temprano vs linitis plstica; los sntomas hacen la diferencia?

Martn Alonso Gmez, Alejandro Concha, William Alberto Otero

El cncer gstrico tiene un patrn de presentacin que va desde el estadio temprano a la linitis plstica, con pronsticos radicalmente diferentes, el primero con sobrevida a cinco aos superior a 90%, el segundo inferior a 5%. Objetivo: identificar si las caractersticas clnicas permiten diferenciar un estado temprano de linitis plstica. Metodologa: se revisaron las bases de datos de la unidad de gastroenterologa y endoscopia digestiva de un hospital de tercer nivel entre julio de 2005 y julio de 2010, seleccionando los casos donde se encontr linitis plstica y cncer gstrico temprano, todos confirmados por patologa. Resultados: se incluyeron 56 pacientes, 15 linitis y 41 cncer temprano. Edad promedio de 61.3 aos, (IC95%54.5-68.2) para linitis y 63 aos para cncer temprano (39-85), 66.6% fueron mujeres y 33.4% hombres en linitis plstica y 51.2% mujeres y 48.8% hombres en cncer temprano. Compromiso del cuerpo en linitis 76.9%, en cncer temprano el cuerpo 29.3%, antro 43.9%. Prdida de peso present un 73.3% en linitis y 26.8% en cncer temprano. No hubo diferencias significativas en sntomas como: vmito, hematemesis, melenas o epigastralgia. El 26.8% de los pacientes tenan antecedente de cncer gstrico Conclusion: los sntomas no son tiles como herramienta para diferenciar cncer gstrico temprano de la linitis plstica, por lo cual se requieren otras estrategias para la deteccin del cncer en estado temprano como podra ser la realizacin de EVDA en los pacientes con antecedentes familiares de este tumor.

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Differentiation of early gastric cancer vs linitis plastica: do symptoms make a difference?

Martn Alonso Gmez, Alejandro Concha, William Alberto Otero

Gastric cancer has a pattern of presentation ranging from early stage to linitis plastica, with radically different prognosis; early cancer with 5-year survival exceeding 90%, and linitis plastica with survival of less than 5%. Objective: identify if the clinical features differentiate an early stage cancer from plastic linitis. Methodology: we reviewed the databases of the unit of gastroenterology and endoscopy of a tertiary hospital between July 2005 to July 2010, selecting those cases where we found plastic linitis and early gastric cancer, all confirmed by pathology. Results: we included 56 patients, 15 with linitis, and 41 with early cancer. Mean age was 61.3 years (95% CI 54.5-68.2) for linitis and 63 years for early cancer (39-85). With plastic linitis, 66.6% were female and 33.4% men, and with early cancer, 51.2% were women and 48.8% were men. Stomach body involvement in linitis was 76.9%; in early cancer, body involvement was 29.3%; antrum involvement was 43.9%. 73.3% of patients with linitis had weight loss and 26.8% had it with early cancer. There were no significant differences in symptoms such as vomiting, hematemesis, melena or epigastralgia. 26.8% of patients had a history of gastric cancer Conclusion: the symptoms are not useful as a tool to differentiate early gastric cancer from linitis plastica, so other strategies are required for detection of early stage cancer, such as the performance of endoscopy in patients with a family history of this tumor 

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Palabras claves / Key Words
linitis plastica, cncer gastrico, signos y sntomas digestivos.linitis plastica, cncer gastrico, signos y sntomas digestivos.
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