EXPLORATORY ANALYSIS OF DIETARY PATTERNS OF PATIENTS WITH GASTRIC ADENOCARCINOMA: A CASE-CONTROL STUDY IN CENTRAL BRAZIL

ABSTRACT Background: Diet is one of the most important modifiable risk factors for the incidence of gastric cancer. Objective: To carry out an exploratory analysis on the dietary patterns of individuals with gastric adenocarcinoma (AdG) in the Central Brazil region. Methods: This is a case-control study carried out from April 2019 to July 2022, in three reference centers for cancer treatment in Goiânia-GO. The cases were patients diagnosed with AdG, the control 1 dyspeptic patients submitted to upper digestive endoscopy and the control 2 patients without gastric complaints. In the three groups, patients aged 18 to 75 years and of both sexes were recruited. To assess food consumption, a Food Frequency Questionnaire validated for the Brazilian population was used. Dietary patterns were identified by Exploratory Factor Analysis (EFA), using principal component analysis as the extraction method, followed by Varimax rotation. Results: The commonality values in the EFA for the foods/food groups consumed by the cases and controls were above 0.30 for all variables. The variance explained by the model was 66.7% for cases, 60.3% for control 1 and 59.7% for control 2. Three eating patterns were identified in cases, control 1 and control 2 that explained 34, 87%, 35.41% and 33.25% respectively of the total variance. The first pattern (“healthy”) was characterized by the consumption of vegetables, fruits, meat and cheese; the second (“unhealthy”) for sausages, pizzas, snacks, ketchup, sweet drinks and instant noodles and the third (“prudent”) rice, beans, meat and fried fish and pasta. Conclusion: This study identified three dietary patterns among patients with AdG and controls in the Central Brazil region. According to the identified patterns, it will be possible to establish a relationship between diet and other epidemiological measures aimed at the prevention of gastric cancer

HELICOBACTER PYLORI INFECTION AND RISK FACTORS IN THE DEVELOPMENT OF GASTRODUODENAL DISEASES IN A POPULATION FROM THE CENTRAL-WEST REGION OF BRAZIL

Resumo: Helicobacter pylori é uma bactéria gram-negativa associada ao desenvolvimento de patologias severas como o adenocarcinoma gástrico. Aproximadamente 50% da população mundial está infectada por este microrganismo. A infecção está associada a fatores socioeconômicos, sociodemográficos e estilo de vida. Em função disso o presente estudo teve o objetivo de avaliar os fatores de risco e patologias gástricas associadas a infecção pela H. pylori. Foram aplicados 117 questionários que contemplavam fatores sociodemográficos, econômicos, sintomatologia e estilo de vida de pacientes submetidos a endoscopia digestiva alta. O diagnóstico foi realizado a partir do exame histopatológico e molecular. A prevalência da infecção foi de 69,2%, sendo 70,4% entre adultos e 79% do sexo feminino. Não foi observada diferença estatística nos níveis educacional, socioeconômico e condições expostas na infância. O hábito de consumir álcool demonstrou significância para a infecção (p=0,049). A sintomatologia mais frequente foi o arroto (p= 0,023). Entre as patologias gástricas, a gastrite foi o desfecho clínico mais encontrado. O conhecimento dos fatores de risco para a infecção bacteriana é de extrema relevância para dar subsídios para implementação de políticas públicas voltadas para a prevenção e erradicação do microrganismo. Palavras-chave: Bactéria. Prevalência. Fatores de risco. Dispepsia.   Abstract: Helicobacter pylori is a gram-negative bacterium associated with the development of severe pathologies such as gastric adenocarcinoma. Approximately 50% of the world population is infected by this microorganism. Infection is associated with socioeconomic, sociodemographic and lifestyle factors. Therefore, the present study had the goal of evaluating the risk factors and gastric pathologies associated with H. pylori infection. A total of 117 questionnaires were used, which included sociodemographic, economic, symptomatology and patient lifestyle factors submitted to upper digestive endoscopy. The diagnosis was done based on histopathological and molecular. The prevalence of infection was 69.2%, being 70.4% among adults and 79% females. No statistical difference was observed in educational, socioeconomic and childhood conditions. The alcohol consumption habit showed significance for the infection (p = 0.049). The most frequent symptomatology was belching (p = 0.023). Among the gastric pathologies, gastritis was the most frequent clinical outcome. The knowledge of the risk factors for bacterial infection is extremely relevant to provide subsidies for the implementation of public policies aimed at the prevention and eradication of the microorganism. Key words: Bacteria. Risk factors. Dyspepsia

PREVALENCE OF HELICOBACTER PYLORI INFECTION IN DYSPEPTIC PATIENTS AND ITS ASSOCIATION WITH CLINICAL RISK FACTORS FOR DEVELOPING GASTRIC ADENOCARCINOMA

ABSTRACT BACKGROUND: In Brazil, particularly in the underdeveloped localities, the prevalence of Helicobacter pylori (H. pylori) infections can range up to 90%. These rates are higher in older individuals and vary by country region. H. pylori infections are linked to the development of gastric pathologies, namely mild to moderate gastritis, gastroenteritis, peptic ulcer, intestinal metaplasia, and gastric cancer. In 1994, this organism was classified by the International Agency for Research on Cancer (IARC) as pertaining to the Group 1 carcinogen for gastric adenocarcinoma etiology. Gastric cancer represents a significant public health problem, being the fourth most common malignant tumor and the second largest cause of cancer-related deaths. OBJECTIVE: To investigate the prevalence of H. pylori infection in dyspeptic patients and determine the link between clinical risk factors and gastric adenocarcinoma diagnosis. METHODS: Polymerase chain reaction (PCR) analysis was employed for molecular diagnosis of gastric tissue biopsies collected from 113 dyspeptic patients at the University Hospital of Federal University of Goiás. Molecular analyses allowed the identification of H. pylori infections. Furthermore, histopathological examinations were performed to determine the clinical risks of developing gastric malignancies. RESULTS: The test results identified 69 individuals older than 44 years, from 75 (66.4%) positive H. pylori infection samples. The prevalence of gastric adenocarcinoma in this study was 1.3%. Among the infected patients, six (8.2%) had high risk, and 67 (91.8%) had a low risk of developing gastric cancer (P<0.05). CONCLUSION: This study shows a high prevalence of H. pylori infection and identifies its contribution to gastric inflammations, which in the long term are manifested in high-risk clinical factors for the development of gastric adenocarcinoma