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Is the association between Helicobacter pylori and gastric cancer confined to CagA-positive strains?
Helicobacter 2004; 9(3):271-7H

Abstract

BACKGROUND

Infection with Helicobacter pylori is associated with an increased risk of gastric cancer. Several studies have indicated that the association differs with strain type. We aimed to find out if infection with strains lacking the virulence factor CagA is linked to gastric cancer risk.

MATERIALS AND METHODS

In a hospital-based case-control study, we collected sera from 100 case patients with a newly diagnosed gastric adenocarcinoma and 96 control patients with diseases unrelated to H. pylori status. Antibodies to H. pylori were analyzed by enzyme-linked immunosorbent assay (ELISA), and antibodies to CagA were detected by immunoblot. Logistic regression was used to obtain odds ratios (ORs) as estimates of relative risk, adjusted for potential confounding.

RESULTS

Among the case patients, 81% were ELISA positive and 86% had antibodies to CagA. The corresponding numbers among the controls were 58% and 55%, respectively. ELISA positivity was associated with an increased risk of gastric adenocarcinoma compared to ELISA negativity (OR for gastric cancer regardless of site 3.9, 95% CI 1.9-8.2). The OR was 7.4 (95% CI 3.3-16.6) for CagA-positive relative to CagA-negative subjects. Among ELISA-positive subjects the presence of CagA antibodies increased the risk 3.6 times (95% CI 1.2-11.1). ELISA-positive CagA-negative infections were associated with a fourfold increased risk (OR = 4.2, 95% CI 1.0-17.0) compared to no infection (ELISA-negative and CagA-negative).

CONCLUSIONS

Although patients with antibodies to CagA have the greatest risk of developing gastric cancer, those with CagA-negative infections run a significantly greater risk than uninfected persons.

Authors+Show Affiliations

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15165264

Citation

Held, Maria, et al. "Is the Association Between Helicobacter Pylori and Gastric Cancer Confined to CagA-positive Strains?" Helicobacter, vol. 9, no. 3, 2004, pp. 271-7.
Held M, Engstrand L, Hansson LE, et al. Is the association between Helicobacter pylori and gastric cancer confined to CagA-positive strains? Helicobacter. 2004;9(3):271-7.
Held, M., Engstrand, L., Hansson, L. E., Bergström, R., Wadström, T., & Nyrén, O. (2004). Is the association between Helicobacter pylori and gastric cancer confined to CagA-positive strains? Helicobacter, 9(3), pp. 271-7.
Held M, et al. Is the Association Between Helicobacter Pylori and Gastric Cancer Confined to CagA-positive Strains. Helicobacter. 2004;9(3):271-7. PubMed PMID: 15165264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is the association between Helicobacter pylori and gastric cancer confined to CagA-positive strains? AU - Held,Maria, AU - Engstrand,Lars, AU - Hansson,Lars-Erik, AU - Bergström,Reinhold, AU - Wadström,Torkel, AU - Nyrén,Olof, PY - 2004/5/29/pubmed PY - 2004/7/9/medline PY - 2004/5/29/entrez SP - 271 EP - 7 JF - Helicobacter JO - Helicobacter VL - 9 IS - 3 N2 - BACKGROUND: Infection with Helicobacter pylori is associated with an increased risk of gastric cancer. Several studies have indicated that the association differs with strain type. We aimed to find out if infection with strains lacking the virulence factor CagA is linked to gastric cancer risk. MATERIALS AND METHODS: In a hospital-based case-control study, we collected sera from 100 case patients with a newly diagnosed gastric adenocarcinoma and 96 control patients with diseases unrelated to H. pylori status. Antibodies to H. pylori were analyzed by enzyme-linked immunosorbent assay (ELISA), and antibodies to CagA were detected by immunoblot. Logistic regression was used to obtain odds ratios (ORs) as estimates of relative risk, adjusted for potential confounding. RESULTS: Among the case patients, 81% were ELISA positive and 86% had antibodies to CagA. The corresponding numbers among the controls were 58% and 55%, respectively. ELISA positivity was associated with an increased risk of gastric adenocarcinoma compared to ELISA negativity (OR for gastric cancer regardless of site 3.9, 95% CI 1.9-8.2). The OR was 7.4 (95% CI 3.3-16.6) for CagA-positive relative to CagA-negative subjects. Among ELISA-positive subjects the presence of CagA antibodies increased the risk 3.6 times (95% CI 1.2-11.1). ELISA-positive CagA-negative infections were associated with a fourfold increased risk (OR = 4.2, 95% CI 1.0-17.0) compared to no infection (ELISA-negative and CagA-negative). CONCLUSIONS: Although patients with antibodies to CagA have the greatest risk of developing gastric cancer, those with CagA-negative infections run a significantly greater risk than uninfected persons. SN - 1083-4389 UR - https://www.unboundmedicine.com/medline/citation/15165264/Is_the_association_between_Helicobacter_pylori_and_gastric_cancer_confined_to_CagA_positive_strains L2 - https://doi.org/10.1111/j.1083-4389.2004.00222.x DB - PRIME DP - Unbound Medicine ER -