Helicobacter pylori et néoplasies gastriques
Tóm tắt
Helicobacter pylori (H. pylori) est un agent carcinogène majeur des lymphomes gastriques du MALT (mucosa associated lymphoid tissue) et des adénocarcinomes gastriques, qui peuvent co-exister chez un même patient. Les lymphomes du MALT peuvent guérir après éradication de l’infection gastrique. Le rôle de H. pylori dans la cancérogenèse gastrique est attesté par les études épidémiologiques, les modèles animaux et son implication dans le processus d’atrophie gastrique, l’hypochlorhydrie et la mutagenèse. Interviennent des facteurs bactériens (îlot de pathogénicité cag...), environnementaux (alimentation...) et de l’hôte (polymorphisme génétique des cytokines inflammatoires). L’éradication préventive de H. pylori est indiquée en cas d’antécédents familiaux de cancer gastrique au premier degré et après résection gastrique partielle pour cancer. D’autres groupes à risque des néoplasies gastriques sont étudiés.
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