Among new criteria for suspecting HDGC is if a patient with diffuse cancer is less than 40 years old. This raises an interesting discussion because of the 20 patients under 40 years of age in our study who had gastric cancer. 18 had diffuse cancer which means that they meet the criteria for consideration of having HDGC. We are conducting an ongoing study to check whether they have CHD1 mutations. If they test positive, we will extend the study to their families in order to identify carriers of the mutation who are asymptomatic. In these cases early detection of this terrible disease that causes high mortality may still be possible. 2. DGC was present in 90% of younger patients. Only one case among the younger patients was early GC. Most of these cases were plastic linitis. 3. Most cases of GC in people under 40 years of age is diffuse. This type of cancer has very poor prognosis, especially since its biological behavior is to spread early metastasis throughout the lymph system. This requires that physicians think of performing upper endoscopy on young people with dyspepsia who do not improve quickly or who exhibit any warning symptoms. 2. Piñeros M, Ferlay J, Murillo R. Cancer incidence estimates at the nation and district levels in Colombia. Salud Pública Mex 2006; 48: 455-465.
Dentro de los nuevos criterios para sospechar el CGHD está el hecho que el paciente con el cáncer difuso tenga menos de 40 años, esto nos plantea una discusión interesante porque de los 20 pacientes con cáncer gástrico menores de 40 años, 18 pacientes tenían cáncer difuso lo cual significa que tienen criterios para considerarlos como CGHD, lo que nos obligaría a descartar en ellos mutaciones del gen CHD1 estudio en curso caso en el cual si fueran positivos podríamos extender el estudio a sus familiares con el fin de identificar a los portadores de la mutación que aún no tienen síntomas y poderles ofrecer una detección temprana de esa terrible enfermedad que genera una gran mortalidad.