Helicobacter pylori and CagA seropositivity and its association with gastric and oesophageal carcinoma

被引:53
作者
Siman, J. Henrik
Engstrand, Lars
Berglund, Goran
Forsgren, Arne
Floren, Claes-Henrik
机构
[1] Lund Univ, Malmo Univ Hosp, Dept Med, Malmo, Sweden
[2] Karolinska Inst, Dept Med, Stockholm, Sweden
[3] Lund Univ, Malmo Univ Hosp, Dept Med Microbiol, Malmo, Sweden
[4] Lund Univ, Univ Lund Hosp, Dept Med, Lund, Sweden
关键词
CagA; gastric adenocarcinoma; Helicobacter pylori; oesophageal carcinoma; Western blot;
D O I
10.1080/00365520601173863
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective. Helicobacter pylori infection is an established risk factor for non-cardia gastric adenocarcinoma. Infection with H. pylori strains harbouring the cagA pathology island may augment this association. H. pylori infection may at the same time reduce the risk for oesophageal carcinoma. However, prospective data on the association between CagA seropositivity and gastric or oesophageal carcinomas are limited. The purpose of this study was to investigate whether CagA seropositivity among H. pylori seropositive subjects is associated with gastric or oesophageal carcinomas. Material and methods. A nested case-control study was performed in the Malmo Preventive Medicine cohort consisting of 32,906 middle-aged subjects. Tumour cases were identified by the Swedish National Cancer Registry. The Western blot method Helicoblot 2.1 was used to detect H. pylori and CagA seropositivity. Results. Non-cardia gastric adenocarcinoma was associated with H. pylori seropositivity, odds ratio 17.8 (95% CI: 4.2 - 74.8; 67 cases). The odds ratio for CagA seropositivity among H. pylori seropositive subjects was 9.7 ( 95% CI: 1.5 - infinity). No significant associations were found between cardia gastric adenocarcinoma and H. pylori or CagA seropositivity among H. pylori seropositive subjects; odds ratios were 1.5 ( 95% CI: 0.51 - 4.8) and 2.7 ( 95% CI: 0.38 - infinity), respectively ( 24 cases). Oesophageal adenocarcinoma and oesophageal squamous cell carcinoma were not significantly associated with H. pylori seropositivity or with CagA seropositivity among H. pylori seropositive subjects; the odds ratios associated with oesophageal adenocarcinoma were 0.46 ( 95% CI: 0.07 - 2.6) and 0.38 ( 95% CI: 0.02 - 24), respectively. Corresponding odds ratios for oesophageal squamous cell carcinoma were 0.44 ( 95% CI: 0.15 - 1.2; 37 cases) and 2.0 ( 95% CI: 0.24 - infinity), respectively. Conclusions. CagA seropositivity among H. pylori seropositive subjects is a risk factor for non-cardia gastric adenocarcinoma.
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页码:933 / 940
页数:8
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