{"id":13691,"date":"2022-09-29T06:46:00","date_gmt":"2022-09-29T06:46:00","guid":{"rendered":"https:\/\/endoscopiaterapeutica.net\/pt\/?p=13691"},"modified":"2023-08-26T21:31:18","modified_gmt":"2023-08-26T21:31:18","slug":"cancer-gastrico-hereditario","status":"publish","type":"post","link":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/","title":{"rendered":"C\u00e2ncer G\u00e1strico Heredit\u00e1rio"},"content":{"rendered":"\n

Autores: Marcus Fernando Kodama Pertille Ramos e \u00cdtalo Beltr\u00e3o Pereira Sim\u00f5es<\/em><\/p>\n\n\n\n

A maioria dos casos de c\u00e2ncer g\u00e1strico (CG) s\u00e3o espor\u00e1dicos, mas cerca de 10% apresentam agrega\u00e7\u00e3o familiar e 1 a 3% possuem uma causa heredit\u00e1ria. O conhecimento das s\u00edndromes heredit\u00e1rias como fator causal do c\u00e2ncer colorretal (CCR) \u00e9 bem difundido, mas no CG isso \u00e9 menos divulgado, fato que pode prejudicar o diagn\u00f3stico precoce e o seguimento adequado. <\/p>\n\n\n\n

O CG heredit\u00e1rio pode ocorrer associado a presen\u00e7as de polipose ou n\u00e3o, como no caso das s\u00edndromes do C\u00e2ncer G\u00e1strico Difuso Heredit\u00e1rio, Li-Fraumeni<\/em>, BRCA1, BRCA2 e Lynch<\/em>. Nesse artigo descreveremos brevemente as principais s\u00edndromes de CG heredit\u00e1rio associadas \u00e0 polipose deixando as n\u00e3o associadas para um artigo futuro.<\/p>\n\n\n\n

1<\/strong>. CG HEREDIT\u00c1RIO ASSOCIADO A POLIPOSE<\/strong><\/strong><\/h2>\n\n\n\n

1.1 POLIPOSE ADENOMATOSA FAMILIAR (PAF)<\/em><\/strong><\/h3>\n\n\n\n

A PAF decorre de uma muta\u00e7\u00e3o do gene supressor tumoral do gene APC causando um alt\u00edssimo risco de CCR. <\/p>\n\n\n\n

Cerca de 51 a 88% dos pacientes apresentam p\u00f3lipos g\u00e1stricos principalmente de gl\u00e2ndulas f\u00fandicas (PGF). A incid\u00eancia \u00e9 elevada inclusiva na PAF atenuada. Eles costumam ser numerosos, e o termo polipose g\u00e1strica pode ser empregado apenas quando mais de 20 est\u00e3o presentes. <\/p>\n\n\n\n

Displasia de baixo grau pode estar presente em at\u00e9 44% dos p\u00f3lipos de gl\u00e2ndulas f\u00fandicas. P\u00f3lipos adenomatosos s\u00e3o detectados em cerca de 20% dos pacientes com PAF. <\/p>\n\n\n\n

O rastreamento endosc\u00f3pico alto \u00e9 recomendado no momento da manifesta\u00e7\u00e3o da polipose col\u00f4nica ou a partir de 25 anos. O intervalo de realiza\u00e7\u00e3o vai depender dos achados e tamb\u00e9m de acordo com a necessidade de seguimento de adenoma de papila, quando presente, de acordo como escore de Spigelman.<\/em><\/p>\n\n\n

\n
\"\"
Polipose g\u00e1strica em paciente com PAF. Imagens mostram in\u00fameros p\u00f3lipos em c\u00e1rdia, fundo, corpo e antro.<\/figcaption><\/figure>\n<\/div>\n\n\n

1.2 S\u00cdNDROME DE PEUTZ-JEGHERS (SPJ)<\/em><\/strong><\/h3>\n\n\n\n

A SPJ \u00e9 autoss\u00f4mica dominante, caracterizada pelo desenvolvimento de polipose hamartomatosa gastrointestinal principalmente no jejuno associada a presen\u00e7a de m\u00e1culas melanoc\u00edticas. <\/p>\n\n\n\n

O diagn\u00f3stico cl\u00ednico baseia-se na confirma\u00e7\u00e3o da presen\u00e7a de p\u00f3lipos hamartomatosos associado com hist\u00f3ria familiar positiva e hiperpigmenta\u00e7\u00e3o de mucosas, dedos e genit\u00e1lia externa. <\/p>\n\n\n\n

P\u00f3lipos g\u00e1stricos s\u00e3o detectados em 25% dos casos, comparados com 70-90 % encontrados no intestino delgado e 50% no c\u00f3lon. O aspecto morfol\u00f3gico do p\u00f3lipo g\u00e1strico na SPJ assemelha-se a um padr\u00e3o viloso prolifera\u00e7\u00e3o epitelial hiperpl\u00e1sica sendo dif\u00edcil distinguir do p\u00f3lipo juvenil e hiperpl\u00e1sico. <\/p>\n\n\n\n

Displasia \u00e9 raramente detectada nos p\u00f3lipos mas indiv\u00edduos com SPJ tem 29% risco de desenvolver CG principalmente do tipo intestinal. <\/p>\n\n\n\n

Rastreamento deve ser iniciado precocemente na inf\u00e2ncia com endoscopia inicial com periodicidade dependendo dos achados. A partir dos 50 anos, o risco de CG aumenta e a periodicidade deve ser mais frequente entre 1 a 2 anos.<\/p>\n\n\n

\n
\"\"
Sequ\u00eancia de imagem mostrando p\u00f3lipo em regi\u00e3o de corpo g\u00e1strico em paciente com S\u00edndrome de Peutz-Jeghers<\/em>, imagens inferiores com magnifica\u00e7\u00e3o de imagem.<\/figcaption><\/figure>\n<\/div>\n\n\n

1.3 S\u00cdNDROME DA POLIPOSE JUVENIL<\/em><\/strong><\/h3>\n\n\n\n

S\u00edndrome autoss\u00f4mica dominante que leva ao desenvolvimento de p\u00f3lipos em todo trato gastrointestinal principalmente no c\u00f3lon e reto. <\/p>\n\n\n\n

Crit\u00e9rios para suspeita cl\u00ednica da s\u00edndrome incluem mais de 5 p\u00f3lipos juvenis colorretais, p\u00f3lipos juvenis ao longo do trato gastrointestinal ou mais de 1 p\u00f3lipo juvenil com hist\u00f3ria familiar positiva. O diagn\u00f3stico definitivo \u00e9 realizado de um dos crit\u00e9rios de suspeita cl\u00ednica na presen\u00e7a dos genes BMPR1A<\/em> e SMAD4<\/em> no teste gen\u00e9tico. <\/p>\n\n\n\n

Os p\u00f3lipos juvenis s\u00e3o p\u00f3lipos hamartomatosos que se desenvolvem a partir de um tecido normal do trato gastrointestinal. O aspecto endosc\u00f3pico habitualmente \u00e9 de um p\u00f3lipo pediculado, multilobado, macio variando desde pequenos p\u00f3lipos at\u00e9 p\u00f3lipos gigantes. Em at\u00e9 75% dos casos existem outros tipos de p\u00f3lipos em conjunto.  Polipose g\u00e1strica severa pode ocorrer causando anemia, hemat\u00eamese, enteropatia com perda proteica e sintomas obstrutivos. Progress\u00e3o para CG ocorre em at\u00e9 21% dos casos com m\u00e9dia de idade de 58 anos. <\/p>\n\n\n\n

Rastreamento endosc\u00f3pico \u00e9 recomendado a partir da adolesc\u00eancia com endoscopias anuais.<\/p>\n\n\n\n

\n

Saiba mais sobre a polipose juvenil clicando neste post<\/a><\/strong><\/p>\n<\/blockquote>\n\n\n

\n
\"\"
Imagens superiores mostram p\u00f3lipo juvenil hamartomatoso em regi\u00e3o da c\u00e1rdia em paciente com polipose juvenil. Imagens inferiores mostram os diferentes aspectos e tamanho dos p\u00f3lipos encontrados na s\u00edndrome.<\/figcaption><\/figure>\n<\/div>\n\n\n

1.4 POLIPOSE ASSOCIADA AO MUTYH (MAP)<\/em><\/strong><\/h3>\n\n\n\n

MAP \u00e9 uma s\u00edndrome rara, autoss\u00f4mica recessiva, associada com muta\u00e7\u00e3o no gene MUTYH que participa de processos de reparo de DNA. Pacientes com MAP tem predisposi\u00e7\u00e3o para o CCR, mama e ov\u00e1rio. <\/p>\n\n\n\n

P\u00f3lipos g\u00e1stricos s\u00e3o detectados em cerca de 10 a 33% dos casos e a maioria adenomas e PGF. <\/p>\n\n\n\n

O risco de CG \u00e9 baixo (2%) mas ocorre em pacientes mais jovens (mediana de 38 anos). Por outro lado, o risco de c\u00e2ncer duodenal \u00e9 alto podendo ocorrer em 17% dos casos.<\/p>\n\n\n\n

1.5 ADENOCARCINOMA G\u00c1STRICO COM POLIPOSE PROXIMAL (GAPPS)<\/em><\/strong><\/h3>\n\n\n\n

Essa s\u00edndrome \u00e9 caracterizada pelo desenvolvimento de uma polipose g\u00e1strica proximal incluindo o fundo e corpo formando um tapete de pequenos p\u00f3lipos usualmente menores que 1 cm. O tipo histol\u00f3gico dos p\u00f3lipos \u00e9 variado podendo ser PGF, hiperpl\u00e1sico, adenomas e mistos. <\/p>\n\n\n\n

Os crit\u00e9rios para diagn\u00f3stico cl\u00ednico incluem detec\u00e7\u00e3o de mais de 100 p\u00f3lipos ou mais de 30 p\u00f3lipos com hist\u00f3ria familiar positiva em parente de primeiro grau, p\u00f3lipos restritos ao corpo e fundo sem a presen\u00e7a de p\u00f3lipos colorretais, morfologia de PGF com \u00e1reas de displasia ou carcinoma, exclus\u00e3o de outras s\u00edndromes e uso de inibidor de bomba de pr\u00f3tons. <\/p>\n\n\n\n

S\u00e9rie de casos relataram incid\u00eancia de 12,7% de CG, todos do tipo intestinal. <\/p>\n\n\n\n

Seguimento endosc\u00f3pico deve ser realizado, mas em casos com m\u00faltiplos p\u00f3lipos a avalia\u00e7\u00e3o de p\u00f3lipos com sinais de degenera\u00e7\u00e3o pode ficar prejudicada sendo indicada a gastrectomia total.<\/p>\n\n\n

\n
\"\"
Imagens de GAPPS evidenciando acometimento de corpo e fundo com diminui\u00e7\u00e3o progressiva no n\u00famero de p\u00f3lipos no est\u00f4mago distal.<\/figcaption><\/figure>\n<\/div>\n\n
\n
\"\"<\/a>
Tabela com resumo das principais caracter\u00edsticas das s\u00edndromes gen\u00e9ticas relacionadas com o c\u00e2ncer g\u00e1strico heredit\u00e1rio, dividindo-as em associadas e n\u00e3o associadas a polipose do trato gastrointestinal.<\/figcaption><\/figure>\n<\/div>\n\n\n

Para saber mais sobre este tema e outros relacionados, acesse o site Gastropedia clicando aqui!<\/a><\/h3>\n\n\n\n

<\/p>\n\n\n\n

Refer\u00eancias<\/strong><\/h2>\n\n\n\n
    \n
  1. Clauditz TS, Moore M, Setia N, et al. Syndromic gastric polyposis and hereditary gastric cancers. Diagnostic Histopathologic<\/em> 2019; 26(1):39-46.<\/li>\n\n\n\n
  2. Mahon SM. Hereditary Polyposis Syndromes. Gentics and Genomics 2018; 22(2): 151-6<\/li>\n\n\n\n
  3. Cardoso DM. S\u00edndromes de polipose colorretal. Endoscopia<\/strong><\/a> Terap\u00eautica; 2020. Dispon\u00edvel em: https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/sindromes-de-polipose-colorretal\/<\/li>\n<\/ol>\n\n\n\n

    Como citar este artigo<\/strong><\/h2>\n\n\n\n

    Kodama, MFKP e Simoes IBP. C\u00e2ncer g\u00e1strico heredit\u00e1rio. Gastropedia 2022. Dispon\u00edvel em: https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

    Autores: Marcus Fernando Kodama Pertille Ramos e \u00cdtalo Beltr\u00e3o Pereira Sim\u00f5es A maioria dos…<\/p>\n","protected":false},"author":5592,"featured_media":13692,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[151],"tags":[327,480,479,482,481,351],"ano":[309],"tipo":[],"volume":[147],"class_list":["post-13691","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-assuntosgerais","tag-cancer-gastrico","tag-gapps","tag-map","tag-mutyh","tag-peutz-jeghers","tag-polipose-juvenil","ano-309","volume-volume-ii"],"yoast_head":"\nC\u00e2ncer G\u00e1strico Heredit\u00e1rio • Endoscopia Terapeutica<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"C\u00e2ncer G\u00e1strico Heredit\u00e1rio\" \/>\n<meta property=\"og:description\" content=\"Autores: Marcus Fernando Kodama Pertille Ramos e \u00cdtalo Beltr\u00e3o Pereira Sim\u00f5es A maioria dos casos de c\u00e2ncer g\u00e1strico (CG) s\u00e3o espor\u00e1dicos, mas cerca de\" \/>\n<meta property=\"og:url\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/\" \/>\n<meta property=\"og:site_name\" content=\"Endoscopia Terapeutica\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/endoscopiaterapeutica\" \/>\n<meta property=\"article:published_time\" content=\"2022-09-29T06:46:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-08-26T21:31:18+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png\" \/>\n\t<meta property=\"og:image:width\" content=\"626\" \/>\n\t<meta property=\"og:image:height\" content=\"692\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Marcus Fernando Kodama Pertille Ramos\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Marcus Fernando Kodama Pertille Ramos\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. tempo de leitura\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/\"},\"author\":{\"name\":\"Marcus Fernando Kodama Pertille Ramos\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/09934ddd60aa339c4b05ecbe316ee9ac\"},\"headline\":\"C\u00e2ncer G\u00e1strico Heredit\u00e1rio\",\"datePublished\":\"2022-09-29T06:46:00+00:00\",\"dateModified\":\"2023-08-26T21:31:18+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/\"},\"wordCount\":1148,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#organization\"},\"image\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png\",\"keywords\":[\"C\u00c2NCER G\u00c1STRICO\",\"GAPPS\",\"MAP\",\"MUTYH\",\"PEUTZ-JEGHERS\",\"POLIPOSE JUVENIL\"],\"articleSection\":[\"Assuntos Gerais\"],\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/\",\"name\":\"C\u00e2ncer G\u00e1strico Heredit\u00e1rio • Endoscopia Terapeutica\",\"isPartOf\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png\",\"datePublished\":\"2022-09-29T06:46:00+00:00\",\"dateModified\":\"2023-08-26T21:31:18+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#breadcrumb\"},\"inLanguage\":\"pt-BR\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png\",\"contentUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png\",\"width\":626,\"height\":692},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/endoscopiaterapeutica.net\/pt\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"C\u00e2ncer G\u00e1strico Heredit\u00e1rio\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#website\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/\",\"name\":\"Endoscopia Terapeutica\",\"description\":\"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.\",\"publisher\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/endoscopiaterapeutica.net\/pt\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"pt-BR\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#organization\",\"name\":\"Endoscopia Terapeutica\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg\",\"contentUrl\":\"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg\",\"width\":720,\"height\":721,\"caption\":\"Endoscopia Terapeutica\"},\"image\":{\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/endoscopiaterapeutica\",\"https:\/\/www.instagram.com\/endoscopy\/\",\"https:\/\/www.youtube.com\/@endoscopyonline\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/09934ddd60aa339c4b05ecbe316ee9ac\",\"name\":\"Marcus Fernando Kodama Pertille Ramos\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"pt-BR\",\"@id\":\"https:\/\/secure.gravatar.com\/avatar\/6be959e8ca397baec394310b9b72328abf7094f5cc5ddfbd2a3b58a9263b2f9f?s=96&d=mm&r=g\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/6be959e8ca397baec394310b9b72328abf7094f5cc5ddfbd2a3b58a9263b2f9f?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/6be959e8ca397baec394310b9b72328abf7094f5cc5ddfbd2a3b58a9263b2f9f?s=96&d=mm&r=g\",\"caption\":\"Marcus Fernando Kodama Pertille Ramos\"},\"description\":\"Cirurgi\u00e3o do Aparelho Digestivo Professor Livre-Docente da Faculdade de Medicina da USP\",\"url\":\"https:\/\/endoscopiaterapeutica.net\/pt\/author\/kodama\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"C\u00e2ncer G\u00e1strico Heredit\u00e1rio • Endoscopia Terapeutica","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/","og_locale":"pt_BR","og_type":"article","og_title":"C\u00e2ncer G\u00e1strico Heredit\u00e1rio","og_description":"Autores: Marcus Fernando Kodama Pertille Ramos e \u00cdtalo Beltr\u00e3o Pereira Sim\u00f5es A maioria dos casos de c\u00e2ncer g\u00e1strico (CG) s\u00e3o espor\u00e1dicos, mas cerca de","og_url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/","og_site_name":"Endoscopia Terapeutica","article_publisher":"https:\/\/www.facebook.com\/endoscopiaterapeutica","article_published_time":"2022-09-29T06:46:00+00:00","article_modified_time":"2023-08-26T21:31:18+00:00","og_image":[{"width":626,"height":692,"url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png","type":"image\/png"}],"author":"Marcus Fernando Kodama Pertille Ramos","twitter_card":"summary_large_image","twitter_misc":{"Escrito por":"Marcus Fernando Kodama Pertille Ramos","Est. tempo de leitura":"7 minutos"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#article","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/"},"author":{"name":"Marcus Fernando Kodama Pertille Ramos","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/09934ddd60aa339c4b05ecbe316ee9ac"},"headline":"C\u00e2ncer G\u00e1strico Heredit\u00e1rio","datePublished":"2022-09-29T06:46:00+00:00","dateModified":"2023-08-26T21:31:18+00:00","mainEntityOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/"},"wordCount":1148,"commentCount":0,"publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png","keywords":["C\u00c2NCER G\u00c1STRICO","GAPPS","MAP","MUTYH","PEUTZ-JEGHERS","POLIPOSE JUVENIL"],"articleSection":["Assuntos Gerais"],"inLanguage":"pt-BR","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/","name":"C\u00e2ncer G\u00e1strico Heredit\u00e1rio • Endoscopia Terapeutica","isPartOf":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website"},"primaryImageOfPage":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage"},"thumbnailUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png","datePublished":"2022-09-29T06:46:00+00:00","dateModified":"2023-08-26T21:31:18+00:00","breadcrumb":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#breadcrumb"},"inLanguage":"pt-BR","potentialAction":[{"@type":"ReadAction","target":["https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/"]}]},{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#primaryimage","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2022\/09\/image-7.png","width":626,"height":692},{"@type":"BreadcrumbList","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/assuntosgerais\/cancer-gastrico-hereditario\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/endoscopiaterapeutica.net\/pt\/"},{"@type":"ListItem","position":2,"name":"C\u00e2ncer G\u00e1strico Heredit\u00e1rio"}]},{"@type":"WebSite","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#website","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","name":"Endoscopia Terapeutica","description":"O Jornal Endoscopia Terap\u00eautica tem como objetivo compartilhar experi\u00eancias da pr\u00e1tica di\u00e1ria, al\u00e9m de prover atualiza\u00e7\u00f5es e discuss\u00f5es sobre endoscopia digestiva.","publisher":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/endoscopiaterapeutica.net\/pt\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"pt-BR"},{"@type":"Organization","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#organization","name":"Endoscopia Terapeutica","url":"https:\/\/endoscopiaterapeutica.net\/pt\/","logo":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/","url":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","contentUrl":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-content\/uploads\/2023\/09\/endter.jpg","width":720,"height":721,"caption":"Endoscopia Terapeutica"},"image":{"@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/endoscopiaterapeutica","https:\/\/www.instagram.com\/endoscopy\/","https:\/\/www.youtube.com\/@endoscopyonline"]},{"@type":"Person","@id":"https:\/\/endoscopiaterapeutica.net\/pt\/#\/schema\/person\/09934ddd60aa339c4b05ecbe316ee9ac","name":"Marcus Fernando Kodama Pertille Ramos","image":{"@type":"ImageObject","inLanguage":"pt-BR","@id":"https:\/\/secure.gravatar.com\/avatar\/6be959e8ca397baec394310b9b72328abf7094f5cc5ddfbd2a3b58a9263b2f9f?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/6be959e8ca397baec394310b9b72328abf7094f5cc5ddfbd2a3b58a9263b2f9f?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/6be959e8ca397baec394310b9b72328abf7094f5cc5ddfbd2a3b58a9263b2f9f?s=96&d=mm&r=g","caption":"Marcus Fernando Kodama Pertille Ramos"},"description":"Cirurgi\u00e3o do Aparelho Digestivo Professor Livre-Docente da Faculdade de Medicina da USP","url":"https:\/\/endoscopiaterapeutica.net\/pt\/author\/kodama\/"}]}},"_links":{"self":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/13691","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/users\/5592"}],"replies":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/comments?post=13691"}],"version-history":[{"count":7,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/13691\/revisions"}],"predecessor-version":[{"id":17032,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/posts\/13691\/revisions\/17032"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media\/13692"}],"wp:attachment":[{"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/media?parent=13691"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/categories?post=13691"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tags?post=13691"},{"taxonomy":"ano","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/ano?post=13691"},{"taxonomy":"tipo","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/tipo?post=13691"},{"taxonomy":"volume","embeddable":true,"href":"https:\/\/endoscopiaterapeutica.net\/pt\/wp-json\/wp\/v2\/volume?post=13691"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}