Helicobacter pylori infection: independent risk indicator of gastric adenocarcinoma.
BACKGROUND
Helicobacter pylori has been implicated as a possible etiologic factor in gastric cancer. This case control study was performed to determine the association between H. pylori and gastric cancer, taking into account the possibility of confounding by other background factors.


METHODS
Sera were collected from 112 incident case patients with gastric cancer and 103 control patients with nongastroenterological diseases, who were frequency-matched with respect to age and sex. Immunoglobulin G antibodies to H. pylori were identified using the HM-CAP immunoassay (Enteric Products Inc., Wesbury, NY).


RESULTS
The prevalence of H. pylori seropositivity was significantly higher (P = 0.002) among case patients than control patients. The odds ratio (OR) was 2.60 (95% confidence interval, 1.35-5.02). The increased OR associated with H. pylori infection was confined to tumors with a noncardia location (OR, 3.06) and men (OR, 4.27). OR increased with decreasing age at cancer diagnosis to reach 9.33 in patients < 60 years of age. Multivariate logistic regression analysis was used as control for potential confounding, but the elevated OR associated with H. pylori infection remained significantly increased.


CONCLUSIONS
The results support the hypothesis of H. pylori infection as an independent risk indicator of gastric cancer.
Hansson
L E
LE
Department of Surgery, University Hospital, Uppsala, Sweden.
Engstrand
L
L
Nyrén
O
O
Evans
D J
DJ
Lindgren
A
A
Bergström
R
R
Andersson
B
B
Athlin
L
L
Bendtsen
O
O
Tracz
P
P
D000230:Adenocarcinoma / Q000453:epidemiology / Q000382:microbiology*; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000032:analysis / Q000276:immunology; D016022:Case-Control Studies; D005247:Feeding Behavior; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000382:microbiology*
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G