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CONTROVERSIAS ACERCA DE INFECCION POR HELICOBACTER PYLORI Y EPIDEMIOLOGIA DEL CANCER GASTRICO

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Se cree que la infección por H. pylori se asocia con la aparición de cáncer gástrico, pero muchos estudios han arrojado resultados contradictorios. En la actualidad, H. pylori no parece tener una asociación de tipo "causa y efecto" con el cáncer gástrico. Se postula que la clasificación de este patógeno dentro del grupo de los carcinógenos humanos del grupo 1 fue prematura.
Autor:
Matthew Tanko
Columnista Experto de SIIC

Institución:
University of Botswana School of Medicine

Artículos publicados por Matthew Tanko
Coautores
Sandro Vento* Francesca Cainelli* 
University of Botswana School of Medicine, Gaborone, Botswana*
Recepción del artículo
20 de Septiembre, 2011 		Aprobación
5 de Mayo, 2012
Primera edición
24 de Julio, 2012 		Segunda edición, ampliada y corregida
7 de Junio, 2021

CONTROVERSIAS ACERCA DE INFECCION POR HELICOBACTER PYLORI Y EPIDEMIOLOGIA DEL CANCER GASTRICO

Resumen
Se cree que la infección por Helicobacter pylori se asocia con la aparición de cáncer gástrico. De hecho, varios estudios han postulado, probado y supuestamente demostrado esta asociación. Desafortunadamente, muchos de estos estudios han arrojado resultados contradictorios. Al parecer, en algunas ocasiones existe una asociación sólida, pero en otras oportunidades no queda claro si esto es así. Al menos el 50% de todos los estudios destinados a demostrar esta asociación han observado una asociación negativa entre esta bacteria y el cáncer gástrico. Incluso aquellos que han logrado resultados con asociación positiva no son reproducibles, lo que sugiere una falta de consistencia. Por otra parte, los datos epidemiológicos son insuficientes para demostrar la causalidad por sí mismos. Tan es así que los experimentos que se han realizado en animales para establecer un vínculo claro entre la infección y el cáncer gástrico no han sido muy exitosos. Por ende, en la actualidad, Helicobacter pylori no parece tener una asociación de tipo "causa y efecto" con el cáncer gástrico. Creemos que la clasificación de este patógeno por la AIIC en 1994 dentro del grupo de los carcinógenos humanos del grupo 1 fue prematura, y que se justifica realizar una reclasificación de esta bacteria en una categoría más apropiada, debido a la falta de pruebas consistentes.

Palabras clave
Helicobacter pylori, cáncer gástrico, epidemiología


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Helicobacter Pylori Infection and the Epidemiology of Gastric Cancer: Evidence and Controversies

Abstract
Helicobacter pylori infection is thought to be associated with the development of gastric cancer. Indeed several studies have postulated, tested and supposedly proven this association. Unfortunately many of these studies have actually produced conflicting results. It sometimes seems that the association exists and is strong, but at other times there is uncertainty as to whether any material association between this pathogen and gastric cancer can be proven. At least 50% of all studies designed to prove this association have generated results with a negative association between Helicobacter pylori and gastric cancer. Even those that have had positive association results are not reproducible, suggesting a lack of consistency. Moreover, epidemiological evidence alone is inadequate to prove causality. In fact, the few animal experiments that have been conducted to establish a definite link with gastric cancer have not been so successful in doing so. At present therefore, Helicobacter pylori does not seem to have a “cause and effect” association with gastric cancer. We think that the classification of this pathogen by IARC in 1994 as a Group 1 human carcinogen was premature and a re-classification of Helicobacter pylori into a more appropriate category may be warranted due to lack of consistent evidence.

Key words
Helicobacter pylori, gastric cancer, epidemiology


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Especialidades
Principal: Gastroenterología, Oncología
Relacionadas: Anatomía Patológica, Epidemiología, Infectología, Salud Pública



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