24. Theuer CP, de Virgilio C, Keese G, et al. Gastric adenocarcinoma in patients 40 years of age or younger. Am J Surg 1996; 172: 473-6. 25. Lauren P. The two histological main types of gastric carcinomas: Diffuse and so-called intestinal-type carcinoma. Acta Path Microbiol Scand 1965; 64: 31-49. 26. Nakamura R, Saikawa Y, Takahashi T, Takeuchi H, Asanuma H, Yamada Y, Kitagawa Y. Retrospective analysis of prognostic outcome of gastric cancer in Young patients. Int J Clin Oncol 2011; 16: 328-34. 27. Bai Y, Li ZS. Endoscopic, clinicopathological features and prognosis of very Young patients with gastric cancer. J Gastroenterol Hepatol 2011, early release 2011 acceso octubre 8, 2011. 29. Piñeros M, Hernández G, Bray F. Increasig mortality rates of comon malignancies in Colombia. Cancer 2004; 101: 2285-92. 30. International Agency for Research on Cancer IARC, Schistosomes liver flukes and Helicobacter pylori. IARC monograph on the evaluation on carcinogenic risks to humans 1994; 61. 31. IARC 1994, Helicobacter and Cancer Colaborative Group. Gastric Cancer and Helicobacter pylori: a combined analyses of 12 case-control Studies nested within prospective cohorts. Gut 2001; 49: 347-53. 32. Rocco A, Nardone G. Diet H. pylori infection and gastric cancer: evidence and controversies. World J Gastroenterol 2007; 13: 2901-12. 33. Pineda LF, Otero W, Gómez M, Arbeláez V, Otero E. Enfermedad estructural y valor predictivo de la historia clínica en pacientes con dispepsia no investigada. Rev colomb gastroenterol 2004; 191: 13-25. 34. Medina-Franco H, Heslin MJ, Cortes-González R. Clinicopathological char­acteristics of gastric carcinoma in young and elderly patients: a comparative study. Ann Surg Oncol 2000; 7: 515-519. 35. Greene FL, Page DL, Fleming ID, et al, editors. AJCC American Committee on Cancer Cancer Staging Manual. 6edition. New York; Springer- Verlag. 2002. 38. Woodward M, Tunstall-Pedoe H, McColl K. Helicobacter pylori infection reduce systemic availability of dietary vitamina C. Eur J Gastroenterol 2001; 13: 2559-66. 39. Meining A, Morgner A, Mielhke S, et al. Atrophy-metaplasia-dysplasia-carcinoma sequence in the stomach: a reality or merely an hypothesis?. Best Pract Res Gastroenterol 2001; 15: 983-8. 40. El Zimaity HM, Ramchatesingh J, Sabed MA, et al. Gastric Intestinal metaplasia: subtypes and natural history. J Clin Pathol 2001; 54: 679-83. 41. Houghton J, Stoicov C, Nomura S, et al. Gastric cancer originating from bone marrow derived cells. Science 2004; 306: 1568-71. 42. Breaux J, et al. Adenocarcinoma de estómago: Una revisión de 35 años, 71.710 casos. World Journal of Surgery. 1990; 14: 580-586. 44. Fujimoto S, Takahasi M, Ohkubo H, et al. Comparative clinicopathologic fea­tures of early gastric cancer in young and older patients. Surgery 1994; 516-520. 45. Keller G, Vogelsang H, Becker I, et al. Diffuse type gastric and lobular breast carcinoma in a familial gastric cancer patient with an E-cadherin germline mutation. Am J Pathol 1999; 155: 337-342. 46. Guilford P, Hopkins J, Harraway J, et al. E-cadherin germline mutations in familial gastric cancer. Nature 1998; 392: 402-405. 47. Newman EA, Mulholland MW. Prophylactic gastrectomy for hereditary diffuse gastric cancer syndrome. J Am Coll Surg 2006; 202: 612-617. 48. Huntsman DG, Carneiro F, Lewis FR, et al. Early gastric cancer in young, asymptomatic carriers of germ-line E-cadherin mutations. N Engl J Med 2001; 344: 1904-1909. 49. Lewis FR, Mellinger JD, Hayashi A, et al. Prophylactic total gastrectomy for familial gastric cancer. Surgery 2001; 130: 612-619. 50. Chun YS, Lindor NM, Smyrk TC, et al. Germline E-cadherin gene mutations: is prophylactic total gastrectomy indicated? Cancer 2001; 92: 181-187. 51. Blair V, Martin I, Shaw D, et al. Hereditary diffuse gastric cancer: diagnosis and management. Clin Gastroenterol Hepatol 2006; 4: 262-275.
3. La mayoría de los casos de CG en personas menores de 40 años es de la variedad difusa, la cual tiene un pésimo pronóstico ya que su comportamiento biológico es dar metástasis de manera temprana por vía linfática y esto obliga a pensar en la endoscopia alta en personas jóvenes con dispepsia que no mejoren pronto o que presenten síntomas de alarma.