Análisis de las características clínicas, endoscópicas e histopatológicas del cáncer gástrico en pacientes ≤ 40 y > 40 años de edad

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dc.contributor.advisorTovar Fierro, German Manuel
dc.contributor.advisorOchoa Vera, Miguel Enrique
dc.contributor.authorMantilla Ribero, Marta Juliana
dc.contributor.cvlacTovar Fierro, German Manuel [0001575134]spa
dc.contributor.cvlacOchoa Vera, Miguel Enrique [0000898465]spa
dc.contributor.orcidOchoa Vera, Miguel Enrique [0000-0002-4552-3388]spa
dc.contributor.researchgateTovar Fierro, German Manuel [German-Manuel-Tovar-Fierro-2148023345]spa
dc.contributor.researchgateOchoa Vera, Miguel Enrique [Miguel-Enrique-Ochoa-2186675588]spa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialColombiaspa
dc.date.accessioned2021-08-19T22:23:35Z
dc.date.available2021-08-19T22:23:35Z
dc.date.issued2021
dc.degree.nameEspecialista en Medicina Internaspa
dc.description.abstractIntroducción y objetivo: El cáncer gástrico (CG) es la primera causa de muerte por cáncer en Colombia con un pico de incidencia alrededor de la sexta década de vida. Sin embargo, se ha observado un aumento de casos y peor pronóstico en adultos jóvenes. Nuestro objetivo fue evaluar la asociación entre la edad al momento del diagnóstico y las características clínico-patológicas del CG. Materiales y métodos: Análisis de corte transversal de datos secundarios de un registro de pacientes llevados a esofagogastroduodenoscopia (EGD), con diagnostico incidente de CG (enero/2016 – diciembre/2019). Se incluyeron las características clínicas, endoscópicas e histopatológicas. Para el análisis como variable independiente, se categorizó la población en ≤ / > 40 años y se calculó la razón de prevalencia como medida de asociación. Resultados: De 4041 EGD realizadas hubo 259 (6%) casos de adenocarcinoma gástrico de novo confirmado histológicamente. Treinta y seis (14%) de los casos fueron en ≤ 40 años (21/36 en mujeres). La dispepsia (61%) fue el principal síntoma referido seguido por la pérdida de peso (43,6%) y el dolor abdominal (42%). El cuerpo (64%) y antro gástrico (51%) fueron las regiones más comprometidas. El 98% de los diagnósticos de CG se encontraban en estadio avanzado (Bormann III 48% y Bormann IV 27%). El patrón histológico difuso fue significativamente más frecuente en el grupo joven (72 vs 33%, p<0.001) mientras que el patrón intestinal predominó en la población mayor. El sexo masculino y el Bormann II se encontraron como factores asociado a una menor prevalencia de CG en pacientes jóvenes y, la presencia de emesis o ascitis, el compromiso del cuerpo gástrico, el Bormann IV y los subtipos histológicos difuso y mixto se asociacion a una mayor prevalencia de CG en pacientes jóvenes. Conclusiones: El CG en pacientes jóvenes predomina en mujeres, se diagnostica en estadios avanzados y la mayoría son de tipo difuso, lo cual confiere un comportamiento más agresivo.spa
dc.description.abstractenglishIntroduction and aims: Gastric cancer (GC) is the first cause of cancer deaths in Colombia with a peak incidence at the sixth decade of life. However, an increase in cases and a worse prognosis has been observed in young adults. Our objective was to evaluate the association between age at diagnosis and the clinicopathological features of GC. Materials and methods: Cross-sectional analysis of secondary data from a registry of patients undergoing to esophagogastroduodenoscopy (EGD), with an incident diagnosis of GC (january/2016 - december/2019). Symptoms, endoscopic and histopathological findings were included. For the analysis as an independent variable, the population was categorized as ≤ /> 40 years and the prevalence ratio was calculated. Results: Of 4,041 EGDs, there were 259 (6%) histologically confirmed gastric adenocarcinoma cases. Thirty-six (14%) were aged ≤40 years (21/36 in women). Dyspepsia (61%) was the main indication for the procedure followed by weight loss (43.6%) and abdominal pain (42%). The body (64%) and antrum (51%) were the most compromised regions. 98% of GC diagnoses were in advanced stage (Bormann III 48% and Bormann IV 27%). The diffuse histological pattern was significantly more frequent in the young group (72 Vs 33%, p <0.001) while the intestinal pattern predominated in the older population. Male sex and Bormann II were found to be associated with a lower prevalence of GC in young patients. The presence of emesis or ascites, the body involvement, Bormann IV and diffuse and mixed histological subtypes were associated with a higher prevalence of GC in young patients. Conclusion: GC in young patients predominates in women, it is diagnosed in advanced stages and most of it are diffuse type, which confers a more aggressive behavior.spa
dc.description.degreelevelEspecializaciónspa
dc.description.learningmodalityModalidad Presencialspa
dc.description.tableofcontentsPLANTEAMIENTO Y JUSTIFICACIÓN DEL PROBLEMA ......................................................... 1 MARCO TEORICO ..................................................................................................................... 3 Epidemiología .......................................................................................................................... 3 Carcinogénesis gástrica ........................................................................................................... 7 Manifestaciones clínicas .......................................................................................................... 8 Diagnóstico .............................................................................................................................. 9 Clasificación............................................................................................................................. 9 Estadificación......................................................................................................................... 12 Tratamiento ........................................................................................................................... 12 ESTADO DEL ARTE................................................................................................................. 13 PREGUNTA DE INVESTIGACIÓN ........................................................................................... 15 OBJETIVOS .............................................................................................................................. 15 Objetivo general ..................................................................................................................... 15 Objetivos específicos ............................................................................................................. 15 METODOLOGÍA ....................................................................................................................... 16 Tipo de estudio ...................................................................................................................... 16 Población universo................................................................................................................. 16 Población objetivo .................................................................................................................. 16 Criterios de inclusión .............................................................................................................. 16 Criterios de exclusión ............................................................................................................. 16 Muestra.................................................................................................................................. 17 Hipótesis ................................................................................................................................ 17 Variables ................................................................................................................................ 17 Plan de análisis de datos ....................................................................................................... 19 Consideraciones éticas .......................................................................................................... 19 RESULTADOS.......................................................................................................................... 21 Análisis univariado ................................................................................................................. 21 Análisis bivariado ................................................................................................................... 25 DISCUSIÓN .............................................................................................................................. 30 CONCLUSIONES ..................................................................................................................... 33 FORTALEZAS Y LIMITACIONES ............................................................................................. 34 BIBLIOGRÁFIA ........................................................................................................................ 35spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/13928
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programEspecialización en Medicina Internaspa
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.accessrightshttp://purl.org/coar/access_right/c_abf2spa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsInternal medicinespa
dc.subject.keywordsMedicinespa
dc.subject.keywordsMedical sciencesspa
dc.subject.keywordsHealth sciencesspa
dc.subject.keywordsGastric cancerspa
dc.subject.keywordsClinicopathological characteristicsspa
dc.subject.keywordsNeoplasmsspa
dc.subject.keywordsAdenocarcinomaspa
dc.subject.keywordsTumorsspa
dc.subject.keywordsBiopsyspa
dc.subject.lembMedicina internaspa
dc.subject.lembMedicinaspa
dc.subject.lembCiencias médicasspa
dc.subject.lembNeoplasmasspa
dc.subject.lembTumoresspa
dc.subject.lembBiopsiaspa
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalCáncer gástricospa
dc.subject.proposalCaracterísticas clínico-patológicasspa
dc.subject.proposalAdenocarcinomaspa
dc.titleAnálisis de las características clínicas, endoscópicas e histopatológicas del cáncer gástrico en pacientes ≤ 40 y > 40 años de edadspa
dc.title.translatedAnalysis of the clinical, endoscopic and histopathological characteristics of gastric cancer in patients ≤ 40 and> 40 years of agespa
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TM

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