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CagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study

Palli, Domenico; Masala, Giovanna; Del Giudice, Giuseppe; Plebani, Mario; Basso, Daniela; Berti, Duccio; Numans, Mattijs E.; Ceroti, Marco; Peeters, Petra H. M. and de Mesquita, H. Bas Bueno, et al. (2007) In International Journal of Cancer 120(4). p.859-867
Abstract
Helicobacter pylori (H. pylori), atrophic gastritis, dietary and lifestyle factors have been associated with gastric cancer (GC). These factors have been evaluated in a large case-control study nested in the European Prospective Investigation into Cancer and Nutrition carried out in 9 countries, including the Mediterranean area. Participants, enrolled in 1992-1998, provided life-style and dietary information and a blood sample (360,000; mean follow-up: 6.1 years). For 233 GC cases diagnosed after enrolment and their 910 controls individually-matched by center, gender, age and blood donation date H. pylori antibodies (antilysate and antiCagA) and plasma Pepsinogen A (PGA) were measured by ELISA methods. Severe chronic atrophic gastritis... (More)
Helicobacter pylori (H. pylori), atrophic gastritis, dietary and lifestyle factors have been associated with gastric cancer (GC). These factors have been evaluated in a large case-control study nested in the European Prospective Investigation into Cancer and Nutrition carried out in 9 countries, including the Mediterranean area. Participants, enrolled in 1992-1998, provided life-style and dietary information and a blood sample (360,000; mean follow-up: 6.1 years). For 233 GC cases diagnosed after enrolment and their 910 controls individually-matched by center, gender, age and blood donation date H. pylori antibodies (antilysate and antiCagA) and plasma Pepsinogen A (PGA) were measured by ELISA methods. Severe chronic atrophic gastritis (SCAG) was defined as PGA circulating levels < 22 mu g/l. Overall, in a conditional logistic regression analysis adjusted for education, smoke, weight and consumption of total vegetables, fruit, red and preserved meat, H. pylori seropositivity was associated with GC risk. Subjects showing only antibodies anti-H. pylori lysate, however, were not at increased risk, while those with antiCagA antibodies had a 3.4-fold increased risk. Overall, the odds ratio associated with SCAG was 3.3 (95% CI 2.2-5.2). According to site, the risk of noncardia GC associated with CagA seropositivity showed a further increase (OR 6.5; 95% CI 3.3-12.6); on the other hand, a ten-fold increased risk of cardia GC was associated with SCAG (OR 11.0; 95% C1 3.0-40.9). These results support the causal relationship between H. pylori CagA+ strains infection, and GC in these European populations even after taking into account dietary habits. This association was limited to distal GC, while serologically defined SCAG was strongly associated with cardia GC, thus suggesting a divergent risk pattern for these 2 sites. (c) 2006 Wiley-Liss, Inc. (Less)
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keywords
chronic, pepsinogen, epidemiology, Helicobacter pylori, stomach cancer, atrophic gastritis
in
International Journal of Cancer
volume
120
issue
4
pages
859 - 867
publisher
John Wiley & Sons
external identifiers
  • wos:000243704100018
  • scopus:33846588810
ISSN
0020-7136
DOI
10.1002/ijc.22435
language
English
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yes
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be42b972-9ef6-49ee-a163-9d29daac56c8 (old id 676225)
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2007-12-14 15:35:44
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2017-08-20 03:28:42
@article{be42b972-9ef6-49ee-a163-9d29daac56c8,
  abstract     = {Helicobacter pylori (H. pylori), atrophic gastritis, dietary and lifestyle factors have been associated with gastric cancer (GC). These factors have been evaluated in a large case-control study nested in the European Prospective Investigation into Cancer and Nutrition carried out in 9 countries, including the Mediterranean area. Participants, enrolled in 1992-1998, provided life-style and dietary information and a blood sample (360,000; mean follow-up: 6.1 years). For 233 GC cases diagnosed after enrolment and their 910 controls individually-matched by center, gender, age and blood donation date H. pylori antibodies (antilysate and antiCagA) and plasma Pepsinogen A (PGA) were measured by ELISA methods. Severe chronic atrophic gastritis (SCAG) was defined as PGA circulating levels &lt; 22 mu g/l. Overall, in a conditional logistic regression analysis adjusted for education, smoke, weight and consumption of total vegetables, fruit, red and preserved meat, H. pylori seropositivity was associated with GC risk. Subjects showing only antibodies anti-H. pylori lysate, however, were not at increased risk, while those with antiCagA antibodies had a 3.4-fold increased risk. Overall, the odds ratio associated with SCAG was 3.3 (95% CI 2.2-5.2). According to site, the risk of noncardia GC associated with CagA seropositivity showed a further increase (OR 6.5; 95% CI 3.3-12.6); on the other hand, a ten-fold increased risk of cardia GC was associated with SCAG (OR 11.0; 95% C1 3.0-40.9). These results support the causal relationship between H. pylori CagA+ strains infection, and GC in these European populations even after taking into account dietary habits. This association was limited to distal GC, while serologically defined SCAG was strongly associated with cardia GC, thus suggesting a divergent risk pattern for these 2 sites. (c) 2006 Wiley-Liss, Inc.},
  author       = {Palli, Domenico and Masala, Giovanna and Del Giudice, Giuseppe and Plebani, Mario and Basso, Daniela and Berti, Duccio and Numans, Mattijs E. and Ceroti, Marco and Peeters, Petra H. M. and de Mesquita, H. Bas Bueno and Buchner, Frederike L. and Clavel-Chapelon, Francoise and Boutron-Ruault, Marie-Christine and Krogh, Vittorio and Saieva, Calogero and Vineis, Paolo and Panico, Salvatore and Tumino, Rosario and Nyren, Olof and Simán, Henrik and Berglund, Göran and Hallmans, Goran and Sanchez, Maria-Jose and Larranaga, Nerea and Barricarte, Aurelio and Navarro, Carmen and Quiros, Jose R. and Key, Tim and Allen, Naomi and Bingham, Sheila and Khaw, Kay Tee and Boeing, Heiner and Weikert, Cornelia and Linseisen, Jakob and Nagel, Gabriele and Overvad, Kim and Thomsen, Reimar W. and Tjonneland, Anne and Olsen, Anja and Trichoupoulou, Antonia and Trichopoulos, Dimitrios and Arvaniti, Athina and Pera, Guillem and Kaaks, Rudolf and Jenab, Mazda and Ferrari, Pietro and Nesi, Gabriella and Carneiro, Fatima and Riboli, Elio and Gonzalez, Carlos A.},
  issn         = {0020-7136},
  keyword      = {chronic,pepsinogen,epidemiology,Helicobacter pylori,stomach cancer,atrophic gastritis},
  language     = {eng},
  number       = {4},
  pages        = {859--867},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {CagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study},
  url          = {http://dx.doi.org/10.1002/ijc.22435},
  volume       = {120},
  year         = {2007},
}