Interactions between CagA and smoking in gastric cancer

被引:21
作者
Wang, Xiao-Qin [1 ]
Yan, Hong [1 ]
Terry, Paul D. [2 ]
Wang, Jian-Sheng [3 ]
Cheng, Li [4 ]
Wu, Wen-An [5 ]
Hu, Sen-Ke [6 ]
机构
[1] Xi An Jiao Tong Univ, Dept Stat & Epidemiol, Sch Med, Xian 710061, Shaanxi Prov, Peoples R China
[2] Univ Tennessee, Dept Publ Hlth, Knoxville, TN 37996 USA
[3] Xi An Jiao Tong Univ, Affiliated Hosp 1, Sch Med, Dept Thorac Oncosurg, Xian 710061, Shaanxi Prov, Peoples R China
[4] Xi An Jiao Tong Univ, Dept Nursing, Sch Med, Xian 710061, Shaanxi Prov, Peoples R China
[5] Hosp Shaanxi Prov, Dept Radiat Oncol Canc, Xian 710061, Shaanxi Prov, Peoples R China
[6] Xi An Jiao Tong Univ, Lab Ctr, Sch Med, Dept Publ Hlth, Xian 710061, Shaanxi Prov, Peoples R China
关键词
Non-cardia cancer; Cytotoxin-associated gene; Helicobacter pylori; Interaction; Smoking; HELICOBACTER-PYLORI INFECTION; INTESTINAL METAPLASIA; COLORECTAL-CANCER; TOBACCO SMOKING; CIGARETTE-SMOKING; BILE REFLUX; RISK; METAANALYSIS; ASSOCIATION; IMMUNOBLOT;
D O I
10.3748/wjg.v17.i28.3330
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
AIM: To examine the interactions between cytotoxin-associated gene (CagA) positive Helicobacter pylori infection and smoking in non-cardiac gastric cancer. METHODS: A case-control study (257 cases and 514 frequency-matched controls) was conducted from September 2008 to July 2010 in Xi'an, China. Cases were newly diagnosed, histologically confirmed non-cardiac cancer. Controls were randomly selected from similar communities to the cases and were further matched by sex and age ( 5 years). A face-to-face interview was performed by the investigators for each participant. Data were obtained using a standardized questionnaire that included questions regarding known or suspected lifestyle and environmental risk factors of gastric cancer. A 5 mL sample of fasting venous blood was taken. CagA infection was serologically detected by enzyme-linked immunosorbent assays. RESULTS: Smoking and CagA infection were statistically significant risk factors of non-cardiac cancer. CagA was categorized in tertiles, and the odds ratio (OR) was 12.4 (95% CI: 6.1-20.3, P = 0.003) for CagA after being adjusted for confounding factors when the high-exposure category was compared with the low-exposure category. Smokers had an OR of 5.4 compared with subjects who never smoked (95% CI: 2.3-9.0, P = 0.002). The OR of non-cardiac cancer was 3.5 (95% CI: 1.8-5.3) for non-smokers with CagA infection, 3.5 (95% CI: 1.9-5.1) for smokers without CagA infection, and 8.7 (95% CI: 5.1-11.9) for smokers with CagA infection compared with subjects without these risk factors. After adjusting for confounding factors, the corresponding ORs of non-cardiac cancer were 3.2 (95% CI: 1.5-6.8), 2.7 (95% CI: 1.3-4.9) and 19.5 (95% CI: 10.3-42.2), respectively. There was a multiplicative interaction between smoking and CagA, with a synergistic factor of 2.257 (Z = 2.315, P = 0.021). CONCLUSION: These findings support a meaningful interaction between CagA and smoking for the risk of gastric cancer which may have implications for its early detection. (C) 2011 Baishideng. All rights reserved.
引用
收藏
页码:3330 / 3334
页数:5
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