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Is the association between Helicobacter pylori and gastric cancer confined to CagA-positive strains?

Held, M; Engstrand, L; Hansson, LE; Bergstrom, R; Wadström, Torkel LU and Nyren, O (2004) In Helicobacter 9(3). p.271-277
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
stomach, Helicobacter pylori, CagA, case-control studies
in
Helicobacter
volume
9
issue
3
pages
271 - 277
publisher
Wiley-Blackwell
external identifiers
  • wos:000221766700012
  • pmid:15165264
  • scopus:2642545156
ISSN
1083-4389
DOI
10.1111/j.1083-4389.2004.00222.x
language
English
LU publication?
yes
id
6df29180-8e47-46dd-91b2-dc3b0e4045e1 (old id 277007)
date added to LUP
2007-10-29 16:04:27
date last changed
2017-01-01 04:26:29
@article{6df29180-8e47-46dd-91b2-dc3b0e4045e1,
  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.},
  author       = {Held, M and Engstrand, L and Hansson, LE and Bergstrom, R and Wadström, Torkel and Nyren, O},
  issn         = {1083-4389},
  keyword      = {stomach,Helicobacter pylori,CagA,case-control studies},
  language     = {eng},
  number       = {3},
  pages        = {271--277},
  publisher    = {Wiley-Blackwell},
  series       = {Helicobacter},
  title        = {Is the association between Helicobacter pylori and gastric cancer confined to CagA-positive strains?},
  url          = {http://dx.doi.org/10.1111/j.1083-4389.2004.00222.x},
  volume       = {9},
  year         = {2004},
}