Metaplasia intestinal gástrica: actualización en epidemiología, diagnóstico, estratificación del riesgo y manejo clínico
DOI:
https://doi.org/10.52787/agl.v56i3.683Palabras clave:
Metaplasia intestinal gástrica, cáncer gástrico, Helicobacter pylori, EGGIM, OLGIM, endoscopiaResumen
La MIG constituye una de las principales lesiones premalignas implicadas en la secuencia de carcinogénesis del adenocarcinoma gástrico de tipo intestinal descrita por Correa. Su identificación representa uno de los pilares de la prevención secundaria del cáncer gástrico, al permitir seleccionar a los pacientes con mayor riesgo de progresión y establecer programas de vigilancia individualizados. En los últimos años se han producido avances relevantes en la comprensión fisiopatológica de la metaplasia intestinal y en las técnicas de diagnóstico endoscópico. Entre los avances más destacados se encuentran la cromoendoscopia virtual, la clasificación EGGIM, los sistemas histológicos OLGA y OLGIM, y la incorporación progresiva de la inteligencia artificial. Las guías clínicas actuales han reforzado el papel de la endoscopia de alta calidad, la estratificación individual del riesgo y la erradicación sistemática de Helicobacter pylori. Esta revisión resume la evidencia más reciente sobre epidemiología, fisiopatología, clasificación, diagnóstico, estratificación del riesgo y manejo clínico de la MIG, comparando las principales guías internacionales e incorporando las perspectivas de la inteligencia artificial aplicada a la endoscopia digestiva.
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