Cascada de Pelayo Correa \u2014 Intervenci\u00f3n M\u00e9dica<\/title>\n<style>\n @page { size: A4; margin: 0; }\n * { box-sizing: border-box; margin: 0; padding: 0; }\n html, body { background: #e8ebee; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: #1a2332; }\n\n .page {\n width: 210mm;\n min-height: 297mm;\n margin: 0 auto;\n background: #fbfaf7;\n padding: 14mm 14mm 12mm 14mm;\n position: relative;\n overflow: hidden;\n }\n\n \/* ----- HEADER ----- *\/\n header {\n border-bottom: 2px solid #1a2332;\n padding-bottom: 5mm;\n margin-bottom: 6mm;\n display: flex;\n justify-content: space-between;\n align-items: flex-end;\n }\n .eyebrow {\n font-size: 8pt;\n letter-spacing: 0.18em;\n text-transform: uppercase;\n color: #8b3a2a;\n font-weight: 600;\n margin-bottom: 2mm;\n }\n h1 {\n font-size: 20pt;\n font-weight: 700;\n line-height: 1.1;\n letter-spacing: -0.01em;\n color: #1a2332;\n }\n h1 em { font-style: italic; color: #8b3a2a; font-weight: 600; }\n .subtitle {\n font-size: 9pt;\n color: #4a5568;\n margin-top: 2mm;\n max-width: 130mm;\n line-height: 1.4;\n }\n .badge {\n font-size: 7pt;\n font-family: 'Courier New', monospace;\n color: #4a5568;\n text-align: right;\n line-height: 1.5;\n letter-spacing: 0.05em;\n }\n .badge strong { color: #1a2332; 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}\n .stage-connector {\n position: absolute;\n top: 14mm;\n bottom: -3.5mm;\n left: 50%;\n transform: translateX(-50%);\n width: 2px;\n background: #1a2332;\n z-index: 1;\n }\n .stage-row:last-of-type .stage-connector { display: none; }\n\n \/* stage content column *\/\n .stage-content h2 {\n font-size: 13pt;\n font-weight: 700;\n line-height: 1.15;\n color: #1a2332;\n margin-bottom: 1.5mm;\n }\n .stage-histology {\n font-size: 8pt;\n color: #4a5568;\n line-height: 1.45;\n font-style: italic;\n margin-bottom: 2mm;\n }\n .stage-tags {\n display: flex;\n gap: 2mm;\n flex-wrap: wrap;\n }\n .tag {\n font-size: 7pt;\n padding: 0.8mm 2mm;\n background: #f0ede6;\n color: #1a2332;\n font-family: 'Courier New', monospace;\n letter-spacing: 0.02em;\n border: 1px solid #d0cec5;\n }\n .tag.risk-low { border-color: #8fa88f; color: #3d5a3d; }\n .tag.risk-mid { border-color: #c9a95c; color: #8b6d1f; }\n .tag.risk-high { border-color: #8b3a2a; color: #8b3a2a; }\n\n \/* intervention column *\/\n .intervention {\n background: #fff;\n border: 1px solid #d0cec5;\n border-left: 3px solid #8b3a2a;\n padding: 2.5mm 3mm;\n display: flex;\n flex-direction: column;\n gap: 1.5mm;\n }\n .intervention-label {\n font-size: 7pt;\n letter-spacing: 0.15em;\n text-transform: uppercase;\n color: #8b3a2a;\n font-weight: 700;\n }\n .intervention-title {\n font-size: 9pt;\n font-weight: 700;\n color: #1a2332;\n line-height: 1.25;\n }\n .intervention-detail {\n font-size: 7.5pt;\n color: #4a5568;\n line-height: 1.4;\n }\n .intervention-detail ul {\n list-style: none;\n padding: 0;\n }\n .intervention-detail li {\n padding-left: 3mm;\n position: relative;\n margin-bottom: 0.5mm;\n }\n .intervention-detail li::before {\n content: '\u203a';\n position: absolute;\n left: 0;\n color: #8b3a2a;\n font-weight: 700;\n }\n\n \/* ----- FOOTER PANELS ----- *\/\n .footer-grid {\n display: grid;\n grid-template-columns: 1fr 1fr;\n gap: 4mm;\n margin-top: 5mm;\n }\n .panel {\n background: #1a2332;\n color: #fbfaf7;\n padding: 3mm 4mm;\n }\n .panel.light {\n background: #f0ede6;\n color: #1a2332;\n border: 1px solid #d0cec5;\n }\n .panel h3 {\n font-size: 8pt;\n letter-spacing: 0.15em;\n text-transform: uppercase;\n margin-bottom: 2mm;\n font-weight: 700;\n opacity: 0.9;\n }\n .panel p, .panel li {\n font-size: 7.5pt;\n line-height: 1.5;\n }\n .panel ul { list-style: none; padding: 0; }\n .panel li { padding-left: 3mm; position: relative; margin-bottom: 0.8mm; }\n .panel.light li::before {\n content: '\u25a0';\n position: absolute; left: 0; color: #8b3a2a; font-size: 6pt; top: 1mm;\n }\n .panel:not(.light) li::before {\n content: '\u25a0';\n position: absolute; left: 0; color: #c9a95c; font-size: 6pt; top: 1mm;\n }\n\n \/* ----- CITATION ----- *\/\n .citation {\n margin-top: 4mm;\n padding-top: 3mm;\n border-top: 1px solid #d0cec5;\n font-size: 6.5pt;\n color: #4a5568;\n font-family: 'Courier New', monospace;\n line-height: 1.5;\n }\n .citation strong { color: #1a2332; }\n\n @media print {\n html, body { background: #fbfaf7; }\n .page { margin: 0; box-shadow: none; }\n }\n<\/style>\n<\/head>\n<body>\n<div class=\"page\">\n\n <header>\n <div>\n <div class=\"eyebrow\">Carcinog\u00e9nesis G\u00e1strica \u00b7 Modelo Histopatol\u00f3gico<\/div>\n <h1>La cascada de <em>Pelayo Correa<\/em><br\/>e intervenci\u00f3n m\u00e9dica por etapa<\/h1>\n <div class=\"subtitle\">Progresi\u00f3n desde mucosa g\u00e1strica normal hasta adenocarcinoma tipo intestinal (Correa, 1988) con puntos accionables de prevenci\u00f3n primaria, secundaria y terciaria seg\u00fan ESGE MAPS II (2019) \/ MAPS III (2025).<\/div>\n <\/div>\n <div class=\"badge\">\n <strong>REF. MAPS II \/ III<\/strong><br\/>\n ESGE \u00b7 EHMSG \u00b7 ESP<br\/>\n 2019 \u2192 2025\n <\/div>\n <\/header>\n\n <div class=\"legend\">\n <div class=\"legend-item\"><span class=\"legend-dot dot-stage\"><\/span> Etapa histol\u00f3gica<\/div>\n <div class=\"legend-item\"><span class=\"legend-dot dot-intervention\"><\/span> Intervenci\u00f3n m\u00e9dica<\/div>\n <div class=\"legend-item\"><span class=\"legend-dot dot-risk\"><\/span> Estratificaci\u00f3n de riesgo<\/div>\n <\/div>\n\n <div class=\"cascade\">\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">1<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Mucosa g\u00e1strica normal<\/h2>\n <div class=\"stage-histology\">Epitelio foveolar y gl\u00e1ndulas ox\u00ednticas\/pil\u00f3ricas intactas. Sin infiltrado inflamatorio.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-low\">Riesgo basal<\/span>\n <span class=\"tag\">Sin vigilancia<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Prevenci\u00f3n primaria<\/div>\n <div class=\"intervention-title\">Educaci\u00f3n y control de factores ambientales<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Reducci\u00f3n de sal, nitratos y ahumados<\/li>\n <li>Cese del tabaquismo<\/li>\n <li>Dieta rica en frutas\/vegetales<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">2<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Gastritis cr\u00f3nica no atr\u00f3fica<\/h2>\n <div class=\"stage-histology\">Infiltrado linfoplasmocitario inducido por <em>Helicobacter pylori<\/em>. Arquitectura glandular preservada.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-mid\">H. pylori (+)<\/span>\n <span class=\"tag\">OLGA 0\u2013I<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Prevenci\u00f3n secundaria \u00b7 clave<\/div>\n <div class=\"intervention-title\">Erradicaci\u00f3n de H. pylori<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Terapia cu\u00e1druple con bismuto (10\u201314 d)<\/li>\n <li>Alternativa: triple con altas dosis IBP<\/li>\n <li>Confirmaci\u00f3n de erradicaci\u00f3n (UBT \/ Ag)<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">3<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Gastritis cr\u00f3nica atr\u00f3fica<\/h2>\n <div class=\"stage-histology\">P\u00e9rdida de gl\u00e1ndulas propias con sustituci\u00f3n por tejido fibroso. Reducci\u00f3n de acidez.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-mid\">OLGA II\u2013IV<\/span>\n <span class=\"tag\">Hipoclorhidria<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Vigilancia endosc\u00f3pica<\/div>\n <div class=\"intervention-title\">Endoscopia HD + cromoendoscopia<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Atrofia leve\/moderada antral: sin vigilancia<\/li>\n <li>Atrofia extensa (OLGA III\u2013IV): EDA cada 3 a\u00f1os<\/li>\n <li>Erradicar H. pylori si persiste<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">4<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Metaplasia intestinal<\/h2>\n <div class=\"stage-histology\">Reemplazo del epitelio g\u00e1strico por epitelio de tipo intestinal (c\u00e9lulas caliciformes). Completa vs. incompleta.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-high\">MI incompleta<\/span>\n <span class=\"tag\">OLGIM III\u2013IV<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Estratificaci\u00f3n (MAPS II\/III)<\/div>\n <div class=\"intervention-title\">Biopsias dirigidas por CE virtual (NBI\/BLI)<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>\u2265 2 sitios: antro + cuerpo (frascos separados)<\/li>\n <li>MI extensa o incompleta: EDA cada 3 a\u00f1os<\/li>\n <li>MI + antecedente familiar CG: vigilancia<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">5<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Displasia (neoplasia intraepitelial)<\/h2>\n <div class=\"stage-histology\">Atipia citol\u00f3gica y arquitectural sin invasi\u00f3n de l\u00e1mina propia. Bajo grado (LGD) vs. alto grado (HGD).<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-high\">LGD \/ HGD<\/span>\n <span class=\"tag\">Viena 3\u20134<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Intervenci\u00f3n endosc\u00f3pica<\/div>\n <div class=\"intervention-title\">Resecci\u00f3n endosc\u00f3pica (ESD \/ EMR)<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Sin lesi\u00f3n visible: reevaluar con CE inmediata<\/li>\n <li>LGD visible: resecci\u00f3n o vigilancia 6\u201312 m<\/li>\n <li>HGD: resecci\u00f3n endosc\u00f3pica en bloque (ESD)<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num terminal\">6<\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Adenocarcinoma g\u00e1strico<\/h2>\n <div class=\"stage-histology\">Invasi\u00f3n de l\u00e1mina propia o m\u00e1s all\u00e1. Tipo intestinal (Laur\u00e9n). Estadificaci\u00f3n TNM.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-high\">C\u00e1ncer temprano<\/span>\n <span class=\"tag risk-high\">T1a \/ T1b+<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Tratamiento curativo<\/div>\n <div class=\"intervention-title\">ESD curativa \u00b7 Gastrectom\u00eda \u00b7 Adyuvancia<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>T1a mucoso: ESD si cumple criterios<\/li>\n <li>T1b submucoso \/ avanzado: gastrectom\u00eda + linfadenectom\u00eda<\/li>\n <li>Erradicar H. pylori post-resecci\u00f3n<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n <\/div>\n\n <div class=\"footer-grid\">\n <div class=\"panel\">\n <h3>Sistemas de estadificaci\u00f3n<\/h3>\n <ul>\n <li><strong style=\"color:#c9a95c\">OLGA<\/strong> \u2014 Operative Link on Gastritis Assessment (atrofia)<\/li>\n <li><strong style=\"color:#c9a95c\">OLGIM<\/strong> \u2014 Operative Link on Gastric Intestinal Metaplasia<\/li>\n <li><strong style=\"color:#c9a95c\">Viena \/ WHO<\/strong> \u2014 clasificaci\u00f3n de displasia y neoplasia<\/li>\n <li><strong style=\"color:#c9a95c\">Par\u00eds<\/strong> \u2014 morfolog\u00eda endosc\u00f3pica de lesiones superficiales<\/li>\n <\/ul>\n <\/div>\n <div class=\"panel light\">\n <h3>Puntos clave cl\u00ednicos<\/h3>\n <ul>\n <li>La erradicaci\u00f3n de <em>H. pylori<\/em> es la \u00fanica intervenci\u00f3n con impacto probado en incidencia de c\u00e1ncer g\u00e1strico<\/li>\n <li>La cromoendoscopia virtual (NBI\/BLI) supera a la luz blanca para dirigir biopsias<\/li>\n <li>La progresi\u00f3n no es inevitable: metaplasia completa tiene riesgo bajo<\/li>\n <\/ul>\n <\/div>\n <\/div>\n\n <div class=\"citation\">\n <strong>REFERENCIAS \u00b7<\/strong>\n Correa P. <em>Human gastric carcinogenesis: a multistep and multifactorial process.<\/em> Cancer Res 1992;52:6735\u201340. \u00b7\n Pimentel-Nunes P et al. <em>MAPS II: ESGE\/EHMSG\/ESP\/SPED guideline update 2019.<\/em> Endoscopy 2019;51(4):365\u2013388. DOI 10.1055\/a-0859-1883. \u00b7\n Dinis-Ribeiro M et al. <em>MAPS III: ESGE\/EHMSG\/ESP guideline update 2025.<\/em> Endoscopy 2025;57(5):504\u2013554. DOI 10.1055\/a-2529-5025.\n <\/div>\n\n<\/div>\n<\/body>\n<\/html>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Cascada de Pelayo Correa \u2014 Intervenci\u00f3n M\u00e9dica Carcinog\u00e9nesis G\u00e1strica \u00b7 Modelo Histopatol\u00f3gico La cascada de Pelayo Correae intervenci\u00f3n m\u00e9dica por etapa Progresi\u00f3n desde mucosa g\u00e1strica normal hasta adenocarcinoma tipo intestinal (Correa, 1988) con puntos accionables de prevenci\u00f3n primaria, secundaria y terciaria seg\u00fan ESGE MAPS II (2019) \/ MAPS III (2025). REF. MAPS II \/ III<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-41092","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages\/41092","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/comments?post=41092"}],"version-history":[{"count":4,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages\/41092\/revisions"}],"predecessor-version":[{"id":41096,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages\/41092\/revisions\/41096"}],"wp:attachment":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/media?parent=41092"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

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\n\t\t\t\t\t\n\n\n\nCascada de Pelayo Correa \u2014 Intervenci\u00f3n M\u00e9dica<\/title>\n<style>\n @page { size: A4; margin: 0; }\n * { box-sizing: border-box; margin: 0; padding: 0; }\n html, body { background: #e8ebee; font-family: 'Helvetica Neue', Helvetica, Arial, sans-serif; color: #1a2332; }\n\n .page {\n width: 210mm;\n min-height: 297mm;\n margin: 0 auto;\n background: #fbfaf7;\n padding: 14mm 14mm 12mm 14mm;\n position: relative;\n overflow: hidden;\n }\n\n \/* ----- HEADER ----- *\/\n header {\n border-bottom: 2px solid #1a2332;\n padding-bottom: 5mm;\n margin-bottom: 6mm;\n display: flex;\n justify-content: space-between;\n align-items: flex-end;\n }\n .eyebrow {\n font-size: 8pt;\n letter-spacing: 0.18em;\n text-transform: uppercase;\n color: #8b3a2a;\n font-weight: 600;\n margin-bottom: 2mm;\n }\n h1 {\n font-size: 20pt;\n font-weight: 700;\n line-height: 1.1;\n letter-spacing: -0.01em;\n color: #1a2332;\n }\n h1 em { font-style: italic; color: #8b3a2a; font-weight: 600; }\n .subtitle {\n font-size: 9pt;\n color: #4a5568;\n margin-top: 2mm;\n max-width: 130mm;\n line-height: 1.4;\n }\n .badge {\n font-size: 7pt;\n font-family: 'Courier New', monospace;\n color: #4a5568;\n text-align: right;\n line-height: 1.5;\n letter-spacing: 0.05em;\n }\n .badge strong { color: #1a2332; font-weight: 700; }\n\n \/* ----- LEGEND ----- *\/\n .legend {\n display: flex;\n gap: 6mm;\n font-size: 7.5pt;\n color: #4a5568;\n margin-bottom: 5mm;\n padding: 2.5mm 3mm;\n background: #f0ede6;\n border-left: 2px solid #1a2332;\n }\n .legend-item { display: flex; align-items: center; gap: 2mm; }\n .legend-dot { width: 8px; height: 8px; border-radius: 50%; flex-shrink: 0; }\n .dot-stage { background: #1a2332; }\n .dot-intervention { background: #8b3a2a; }\n .dot-risk { background: #c9a95c; }\n\n \/* ----- CASCADE ----- *\/\n .cascade {\n display: flex;\n flex-direction: column;\n gap: 0;\n }\n\n .stage-row {\n display: grid;\n grid-template-columns: 22mm 1fr 62mm;\n gap: 4mm;\n align-items: stretch;\n padding: 3.5mm 0;\n border-bottom: 1px dashed #d0cec5;\n position: relative;\n }\n .stage-row:last-of-type { border-bottom: none; }\n\n \/* stage number column *\/\n .stage-num-col {\n display: flex;\n flex-direction: column;\n align-items: center;\n position: relative;\n }\n .stage-num {\n width: 14mm;\n height: 14mm;\n border-radius: 50%;\n background: #1a2332;\n color: #fbfaf7;\n display: flex;\n align-items: center;\n justify-content: center;\n font-size: 14pt;\n font-weight: 700;\n font-family: 'Courier New', monospace;\n z-index: 2;\n flex-shrink: 0;\n }\n .stage-num.terminal { background: #8b3a2a; }\n .stage-connector {\n position: absolute;\n top: 14mm;\n bottom: -3.5mm;\n left: 50%;\n transform: translateX(-50%);\n width: 2px;\n background: #1a2332;\n z-index: 1;\n }\n .stage-row:last-of-type .stage-connector { display: none; }\n\n \/* stage content column *\/\n .stage-content h2 {\n font-size: 13pt;\n font-weight: 700;\n line-height: 1.15;\n color: #1a2332;\n margin-bottom: 1.5mm;\n }\n .stage-histology {\n font-size: 8pt;\n color: #4a5568;\n line-height: 1.45;\n font-style: italic;\n margin-bottom: 2mm;\n }\n .stage-tags {\n display: flex;\n gap: 2mm;\n flex-wrap: wrap;\n }\n .tag {\n font-size: 7pt;\n padding: 0.8mm 2mm;\n background: #f0ede6;\n color: #1a2332;\n font-family: 'Courier New', monospace;\n letter-spacing: 0.02em;\n border: 1px solid #d0cec5;\n }\n .tag.risk-low { border-color: #8fa88f; color: #3d5a3d; }\n .tag.risk-mid { border-color: #c9a95c; color: #8b6d1f; }\n .tag.risk-high { border-color: #8b3a2a; color: #8b3a2a; }\n\n \/* intervention column *\/\n .intervention {\n background: #fff;\n border: 1px solid #d0cec5;\n border-left: 3px solid #8b3a2a;\n padding: 2.5mm 3mm;\n display: flex;\n flex-direction: column;\n gap: 1.5mm;\n }\n .intervention-label {\n font-size: 7pt;\n letter-spacing: 0.15em;\n text-transform: uppercase;\n color: #8b3a2a;\n font-weight: 700;\n }\n .intervention-title {\n font-size: 9pt;\n font-weight: 700;\n color: #1a2332;\n line-height: 1.25;\n }\n .intervention-detail {\n font-size: 7.5pt;\n color: #4a5568;\n line-height: 1.4;\n }\n .intervention-detail ul {\n list-style: none;\n padding: 0;\n }\n .intervention-detail li {\n padding-left: 3mm;\n position: relative;\n margin-bottom: 0.5mm;\n }\n .intervention-detail li::before {\n content: '\u203a';\n position: absolute;\n left: 0;\n color: #8b3a2a;\n font-weight: 700;\n }\n\n \/* ----- FOOTER PANELS ----- *\/\n .footer-grid {\n display: grid;\n grid-template-columns: 1fr 1fr;\n gap: 4mm;\n margin-top: 5mm;\n }\n .panel {\n background: #1a2332;\n color: #fbfaf7;\n padding: 3mm 4mm;\n }\n .panel.light {\n background: #f0ede6;\n color: #1a2332;\n border: 1px solid #d0cec5;\n }\n .panel h3 {\n font-size: 8pt;\n letter-spacing: 0.15em;\n text-transform: uppercase;\n margin-bottom: 2mm;\n font-weight: 700;\n opacity: 0.9;\n }\n .panel p, .panel li {\n font-size: 7.5pt;\n line-height: 1.5;\n }\n .panel ul { list-style: none; padding: 0; }\n .panel li { padding-left: 3mm; position: relative; margin-bottom: 0.8mm; }\n .panel.light li::before {\n content: '\u25a0';\n position: absolute; left: 0; color: #8b3a2a; font-size: 6pt; top: 1mm;\n }\n .panel:not(.light) li::before {\n content: '\u25a0';\n position: absolute; left: 0; color: #c9a95c; font-size: 6pt; top: 1mm;\n }\n\n \/* ----- CITATION ----- *\/\n .citation {\n margin-top: 4mm;\n padding-top: 3mm;\n border-top: 1px solid #d0cec5;\n font-size: 6.5pt;\n color: #4a5568;\n font-family: 'Courier New', monospace;\n line-height: 1.5;\n }\n .citation strong { color: #1a2332; }\n\n @media print {\n html, body { background: #fbfaf7; }\n .page { margin: 0; box-shadow: none; }\n }\n<\/style>\n<\/head>\n<body>\n<div class=\"page\">\n\n <header>\n <div>\n <div class=\"eyebrow\">Carcinog\u00e9nesis G\u00e1strica \u00b7 Modelo Histopatol\u00f3gico<\/div>\n <h1>La cascada de <em>Pelayo Correa<\/em><br\/>e intervenci\u00f3n m\u00e9dica por etapa<\/h1>\n <div class=\"subtitle\">Progresi\u00f3n desde mucosa g\u00e1strica normal hasta adenocarcinoma tipo intestinal (Correa, 1988) con puntos accionables de prevenci\u00f3n primaria, secundaria y terciaria seg\u00fan ESGE MAPS II (2019) \/ MAPS III (2025).<\/div>\n <\/div>\n <div class=\"badge\">\n <strong>REF. MAPS II \/ III<\/strong><br\/>\n ESGE \u00b7 EHMSG \u00b7 ESP<br\/>\n 2019 \u2192 2025\n <\/div>\n <\/header>\n\n <div class=\"legend\">\n <div class=\"legend-item\"><span class=\"legend-dot dot-stage\"><\/span> Etapa histol\u00f3gica<\/div>\n <div class=\"legend-item\"><span class=\"legend-dot dot-intervention\"><\/span> Intervenci\u00f3n m\u00e9dica<\/div>\n <div class=\"legend-item\"><span class=\"legend-dot dot-risk\"><\/span> Estratificaci\u00f3n de riesgo<\/div>\n <\/div>\n\n <div class=\"cascade\">\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">1<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Mucosa g\u00e1strica normal<\/h2>\n <div class=\"stage-histology\">Epitelio foveolar y gl\u00e1ndulas ox\u00ednticas\/pil\u00f3ricas intactas. Sin infiltrado inflamatorio.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-low\">Riesgo basal<\/span>\n <span class=\"tag\">Sin vigilancia<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Prevenci\u00f3n primaria<\/div>\n <div class=\"intervention-title\">Educaci\u00f3n y control de factores ambientales<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Reducci\u00f3n de sal, nitratos y ahumados<\/li>\n <li>Cese del tabaquismo<\/li>\n <li>Dieta rica en frutas\/vegetales<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">2<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Gastritis cr\u00f3nica no atr\u00f3fica<\/h2>\n <div class=\"stage-histology\">Infiltrado linfoplasmocitario inducido por <em>Helicobacter pylori<\/em>. Arquitectura glandular preservada.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-mid\">H. pylori (+)<\/span>\n <span class=\"tag\">OLGA 0\u2013I<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Prevenci\u00f3n secundaria \u00b7 clave<\/div>\n <div class=\"intervention-title\">Erradicaci\u00f3n de H. pylori<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Terapia cu\u00e1druple con bismuto (10\u201314 d)<\/li>\n <li>Alternativa: triple con altas dosis IBP<\/li>\n <li>Confirmaci\u00f3n de erradicaci\u00f3n (UBT \/ Ag)<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">3<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Gastritis cr\u00f3nica atr\u00f3fica<\/h2>\n <div class=\"stage-histology\">P\u00e9rdida de gl\u00e1ndulas propias con sustituci\u00f3n por tejido fibroso. Reducci\u00f3n de acidez.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-mid\">OLGA II\u2013IV<\/span>\n <span class=\"tag\">Hipoclorhidria<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Vigilancia endosc\u00f3pica<\/div>\n <div class=\"intervention-title\">Endoscopia HD + cromoendoscopia<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Atrofia leve\/moderada antral: sin vigilancia<\/li>\n <li>Atrofia extensa (OLGA III\u2013IV): EDA cada 3 a\u00f1os<\/li>\n <li>Erradicar H. pylori si persiste<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">4<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Metaplasia intestinal<\/h2>\n <div class=\"stage-histology\">Reemplazo del epitelio g\u00e1strico por epitelio de tipo intestinal (c\u00e9lulas caliciformes). Completa vs. incompleta.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-high\">MI incompleta<\/span>\n <span class=\"tag\">OLGIM III\u2013IV<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Estratificaci\u00f3n (MAPS II\/III)<\/div>\n <div class=\"intervention-title\">Biopsias dirigidas por CE virtual (NBI\/BLI)<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>\u2265 2 sitios: antro + cuerpo (frascos separados)<\/li>\n <li>MI extensa o incompleta: EDA cada 3 a\u00f1os<\/li>\n <li>MI + antecedente familiar CG: vigilancia<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num\">5<\/div>\n <div class=\"stage-connector\"><\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Displasia (neoplasia intraepitelial)<\/h2>\n <div class=\"stage-histology\">Atipia citol\u00f3gica y arquitectural sin invasi\u00f3n de l\u00e1mina propia. Bajo grado (LGD) vs. alto grado (HGD).<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-high\">LGD \/ HGD<\/span>\n <span class=\"tag\">Viena 3\u20134<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Intervenci\u00f3n endosc\u00f3pica<\/div>\n <div class=\"intervention-title\">Resecci\u00f3n endosc\u00f3pica (ESD \/ EMR)<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>Sin lesi\u00f3n visible: reevaluar con CE inmediata<\/li>\n <li>LGD visible: resecci\u00f3n o vigilancia 6\u201312 m<\/li>\n <li>HGD: resecci\u00f3n endosc\u00f3pica en bloque (ESD)<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n \n <div class=\"stage-row\">\n <div class=\"stage-num-col\">\n <div class=\"stage-num terminal\">6<\/div>\n <\/div>\n <div class=\"stage-content\">\n <h2>Adenocarcinoma g\u00e1strico<\/h2>\n <div class=\"stage-histology\">Invasi\u00f3n de l\u00e1mina propia o m\u00e1s all\u00e1. Tipo intestinal (Laur\u00e9n). Estadificaci\u00f3n TNM.<\/div>\n <div class=\"stage-tags\">\n <span class=\"tag risk-high\">C\u00e1ncer temprano<\/span>\n <span class=\"tag risk-high\">T1a \/ T1b+<\/span>\n <\/div>\n <\/div>\n <div class=\"intervention\">\n <div class=\"intervention-label\">Tratamiento curativo<\/div>\n <div class=\"intervention-title\">ESD curativa \u00b7 Gastrectom\u00eda \u00b7 Adyuvancia<\/div>\n <div class=\"intervention-detail\">\n <ul>\n <li>T1a mucoso: ESD si cumple criterios<\/li>\n <li>T1b submucoso \/ avanzado: gastrectom\u00eda + linfadenectom\u00eda<\/li>\n <li>Erradicar H. pylori post-resecci\u00f3n<\/li>\n <\/ul>\n <\/div>\n <\/div>\n <\/div>\n\n <\/div>\n\n <div class=\"footer-grid\">\n <div class=\"panel\">\n <h3>Sistemas de estadificaci\u00f3n<\/h3>\n <ul>\n <li><strong style=\"color:#c9a95c\">OLGA<\/strong> \u2014 Operative Link on Gastritis Assessment (atrofia)<\/li>\n <li><strong style=\"color:#c9a95c\">OLGIM<\/strong> \u2014 Operative Link on Gastric Intestinal Metaplasia<\/li>\n <li><strong style=\"color:#c9a95c\">Viena \/ WHO<\/strong> \u2014 clasificaci\u00f3n de displasia y neoplasia<\/li>\n <li><strong style=\"color:#c9a95c\">Par\u00eds<\/strong> \u2014 morfolog\u00eda endosc\u00f3pica de lesiones superficiales<\/li>\n <\/ul>\n <\/div>\n <div class=\"panel light\">\n <h3>Puntos clave cl\u00ednicos<\/h3>\n <ul>\n <li>La erradicaci\u00f3n de <em>H. pylori<\/em> es la \u00fanica intervenci\u00f3n con impacto probado en incidencia de c\u00e1ncer g\u00e1strico<\/li>\n <li>La cromoendoscopia virtual (NBI\/BLI) supera a la luz blanca para dirigir biopsias<\/li>\n <li>La progresi\u00f3n no es inevitable: metaplasia completa tiene riesgo bajo<\/li>\n <\/ul>\n <\/div>\n <\/div>\n\n <div class=\"citation\">\n <strong>REFERENCIAS \u00b7<\/strong>\n Correa P. <em>Human gastric carcinogenesis: a multistep and multifactorial process.<\/em> Cancer Res 1992;52:6735\u201340. \u00b7\n Pimentel-Nunes P et al. <em>MAPS II: ESGE\/EHMSG\/ESP\/SPED guideline update 2019.<\/em> Endoscopy 2019;51(4):365\u2013388. DOI 10.1055\/a-0859-1883. \u00b7\n Dinis-Ribeiro M et al. <em>MAPS III: ESGE\/EHMSG\/ESP guideline update 2025.<\/em> Endoscopy 2025;57(5):504\u2013554. DOI 10.1055\/a-2529-5025.\n <\/div>\n\n<\/div>\n<\/body>\n<\/html>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Cascada de Pelayo Correa \u2014 Intervenci\u00f3n M\u00e9dica Carcinog\u00e9nesis G\u00e1strica \u00b7 Modelo Histopatol\u00f3gico La cascada de Pelayo Correae intervenci\u00f3n m\u00e9dica por etapa Progresi\u00f3n desde mucosa g\u00e1strica normal hasta adenocarcinoma tipo intestinal (Correa, 1988) con puntos accionables de prevenci\u00f3n primaria, secundaria y terciaria seg\u00fan ESGE MAPS II (2019) \/ MAPS III (2025). REF. MAPS II \/ III<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-41092","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages\/41092","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/comments?post=41092"}],"version-history":[{"count":4,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages\/41092\/revisions"}],"predecessor-version":[{"id":41096,"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/pages\/41092\/revisions\/41096"}],"wp:attachment":[{"href":"https:\/\/doctorcepeda.com.co\/index.php\/wp-json\/wp\/v2\/media?parent=41092"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}