Helicobacter pylori infection and low serum pepsinogen I level as risk factors for gastric carcinoma.
OBJECTIVE
To study whether examination of CagA antibodies could increase the odds ratio for gastric cancer in a case-control study, and how often other serum markers of gastric cancer risk could be found in Helicobacter pylori -negative patients.


METHODS
H pylori CagA and parietal cell antibodies (PCAs), and serum pepsinogen I (SPGI) levels were compared between patients with gastric cancer and controls who received endoscopic examination due to reasons other than gastrointestinal malignancy.


RESULTS
The odds ratio (OR) for gastric cancer was 2.9 (95% CI 1.4-5.8) in H pylori + patients, and 2.4 (95% CI 1.2-4.9) in CagA+ patients. When results of H pylori and CagA antibodies were combined, OR increased to 5.0 (95% CI 2.5-10.0). Furthermore, if cardia cancer patients were excluded, the OR increased to 6.8 (95% CI 3.1-14.8). Among patients with a low SPGI level, the OR was 12.0 (95% CI 4.1-35.3). However, the risk was significant only in the older age group. The number of patients with low SPGI was significantly higher in H pylori -/CagA+ patients as compared to other cancer patients.


CONCLUSIONS
Examination of both H pylori and CagA antibodies increases the OR for gastric cancer in our case-control study. CagA antibodies are important in detecting previous H pylori infection in advanced atrophic gastritis or cancer when spontaneous decline of H pylori antibodies occurs. SPGI may be helpful in screening elderly gastric cancer patients.
Kokkola
Arto
A
Department of Surgery, Meilahti Hospital, PO Box 340 (Haartmaninkatu 4), FIN-00029 HUS, Finland. arto.kokkola@hus.fi
Louhimo
Johanna
J
Puolakkainen
Pauli
P
Alfthan
Henrik
H
Haglund
Caj
C
Rautelin
Hilpi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D001426:Bacterial Proteins / Q000276:immunology; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010295:Parietal Cells, Gastric / Q000276:immunology; D020116:Pepsinogen A / Q000097:blood*; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013274:Stomach Neoplasms / Q000097:blood / Q000453:epidemiology*
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001323:Autoantibodies; D001426:Bacterial Proteins; D015415:Biomarkers; C080866:cagA protein, Helicobacter pylori; D020116:Pepsinogen A
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