Meta-analysis of the relationship between cagA seropositivity and gastric cancer

被引:452
作者
Huang, JQ
Zheng, GF
Sumanac, K
Irvine, EJ
Hunt, RH
机构
[1] McMaster Univ, Med Ctr, Dept Gastroenterol, Hamilton, ON L8N 3Z5, Canada
[2] Queen Mary Hosp, Dept Gastroenterol, Hong Kong, Hong Kong, Peoples R China
关键词
D O I
10.1053/j.gastro.2003.08.033
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Aims: Reports in the literature regarding the relationship of infection with cagA-positive strains of Helicobacter pylori to gastric cancer over and above H. pylori infection alone are conflicting. The aim of this study was to estimate the magnitude of the risk for gastric cancer associated with cagA seropositivity and to identify any sources of heterogeneity between studies. Methods: A meta-analysis of case-control studies with age- and sex-matched controls, which provided raw data on the infection rates with H. pylori and cagA strains of H. pylori as detected by serology or polymerase chain reaction DNA, was performed. Results: A comprehensive literature search identified 16 qualified studies with 2284 cases and 2770 controls. H. pylori and cagA seropositivity significantly increased the risk for gastric cancer by 2.28- and 2.87-fold, respectively. Among H. pylori-infected populations, infection with cagA-positive strains further increased the risk for gastric cancer by 1.64-fold (95% confidence interval [CI], 1.21-2.24) overall and by 2.01-fold (95% CI, 1.21-3.32) for noncardia gastric cancer. Gastric cancer at the cardia is not associated with H. pylori infection or cagA-positive strains of H. pylori. Patient age and site of gastric cancer contributed to the heterogeneity between studies. Conclusions: Infection with cagA-positive strains of H. pylori increases the risk for gastric cancer over the risk associated with H. pylori infection alone. Searching for cagA status over H. pylori infection may confer additional benefit in identifying populations at greater risk for gastric cancer.
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页码:1636 / 1644
页数:9
相关论文
共 52 条
  • [1] INVITED COMMENTARY - BENEFITS OF HETEROGENEITY IN METAANALYSIS OF DATA FROM EPIDEMIOLOGIC STUDIES
    BERLIN, JA
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 1995, 142 (04) : 383 - 387
  • [2] BLASER MJ, 1995, CANCER RES, V55, P2111
  • [3] Brenner H, 2000, CANCER, V88, P274, DOI 10.1002/(SICI)1097-0142(20000115)88:2<274::AID-CNCR5>3.0.CO
  • [4] 2-9
  • [5] Risk of gastric cancer among smokers infected with Helicobacter pylori
    Brenner, H
    Arndt, V
    Bode, G
    Stegmaier, C
    Ziegler, H
    Stümer, T
    [J]. INTERNATIONAL JOURNAL OF CANCER, 2002, 98 (03) : 446 - 449
  • [6] Chow WH, 1998, CANCER RES, V58, P588
  • [7] HETEROGENEITY IN METAANALYSIS OF DATA FROM EPIDEMIOLOGIC STUDIES - COMMENTARY
    COLDITZ, GA
    BURDICK, E
    MOSTELLER, F
    [J]. AMERICAN JOURNAL OF EPIDEMIOLOGY, 1995, 142 (04) : 371 - 382
  • [8] CORREA P, 1992, CANCER RES, V52, P6735
  • [9] Danesh J, 1999, ALIMENT PHARM THERAP, V13, P851
  • [10] Bias in meta-analysis detected by a simple, graphical test
    Egger, M
    Smith, GD
    Schneider, M
    Minder, C
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 1997, 315 (7109): : 629 - 634