title: Helicobacter pylori infection and low serum pepsinogen I level as risk factors for gastric carcinoma.
abstract: 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.
authors.affiliation: Department of Surgery, Meilahti Hospital, PO Box 340 (Haartmaninkatu 4), FIN-00029 HUS, Finland. arto.kokkola@hus.fi
authors.forename: Arto
authors.initials: A
authors.lastname: Kokkola
authors.forename: Johanna
authors.initials: J
authors.lastname: Louhimo
authors.forename: Pauli
authors.initials: P
authors.lastname: Puolakkainen
authors.forename: Henrik
authors.initials: H
authors.lastname: Alfthan
authors.forename: Caj
authors.initials: C
authors.lastname: Haglund
authors.forename: Hilpi
authors.initials: H
authors.lastname: Rautelin
mesh_terms: 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*
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001323:Autoantibodies; D001426:Bacterial Proteins; D015415:Biomarkers; C080866:cagA protein, Helicobacter pylori; D020116:Pepsinogen A
references.citation: CA Cancer J Clin. 2002 Jan-Feb;52(1):23-47
references.pmid: 11814064
references.citation: Cancer Res. 1995 May 15;55(10):2111-5
references.pmid: 7743510
references.citation: Gut. 2001 Sep;49(3):347-53
references.pmid: 11511555
references.citation: Scand J Gastroenterol. 2000 Sep;35(9):950-6
references.pmid: 11063155
references.citation: J Clin Microbiol. 1998 Apr;36(4):955-7
references.pmid: 9542915
references.citation: Acta Pathol Microbiol Scand. 1965;64:31-49
references.pmid: 14320675
references.citation: Gut. 2000 Apr;46(4):460-3
references.pmid: 10716672
references.citation: Scand J Gastroenterol Suppl. 1997;223:28-34
references.pmid: 9200303
references.citation: Lancet. 1994 Jan 22;343(8891):243-4
references.pmid: 7904707
references.citation: Gastroenterology. 1991 Jul;101(1):167-74
references.pmid: 2044906
references.citation: Lancet. 1992 Apr 11;339(8798):893-5
references.pmid: 1348298
references.citation: Gut. 2003 Jul;52(7):938-41
references.pmid: 12801947
references.citation: Scand J Infect Dis. 1997;29(2):147-51
references.pmid: 9181650
references.citation: Am J Gastroenterol. 2003 Apr;98(4):735-9
references.pmid: 12738449
references.citation: Gastroenterology. 1997 May;112(5):1442-7
references.pmid: 9136820
references.citation: Scand J Gastroenterol. 1996 Jun;31(6):546-50
references.pmid: 8789892
references.citation: Am J Surg Pathol. 1995;19 Suppl 1:S30-6
references.pmid: 7762737
references.citation: J Clin Gastroenterol. 1996 Apr;22(3):182-5
references.pmid: 8724254
references.citation: Epidemiol Infect. 2001 Feb;126(1):37-42
references.pmid: 11293681
references.citation: Gastroenterology. 2001 Oct;121(4):784-91
references.pmid: 11606491
references.citation: Cancer. 1995 Jun 15;75(12):2789-93
references.pmid: 7773928
references.citation: Gut. 1971 Nov;12(11):906-11
references.pmid: 5132222
references.citation: Lancet. 1987 Sep 12;2(8559):633-4
references.pmid: 2887926
references.citation: Lancet. 1995 Jun 17;345(8964):1525-8
references.pmid: 7791437
references.citation: Int J Cancer. 1985 Feb 15;35(2):173-7
references.pmid: 3871738
references.citation: Scand J Gastroenterol. 1974;9(5):441-6
references.pmid: 4850688
references.citation: Lancet. 1984 Jun 16;1(8390):1311-5
references.pmid: 6145023
references.citation: Scand J Gastroenterol. 2000 Feb;35(2):138-41
references.pmid: 10720110
references.citation: Scand J Gastroenterol. 1979;14(2):129-39
references.pmid: 432534
references.citation: Eur J Gastroenterol Hepatol. 1999 Dec;11(12):1365-70
references.pmid: 10654796
references.citation: Lancet. 1993 Aug 7;342(8867):328-31
references.pmid: 8101585
references.citation: Scand J Gastroenterol. 1993 Aug;28(8):705-8
references.pmid: 8210987
references.citation: Gastroenterology. 1982 Jan;82(1):26-33
references.pmid: 7053333
references.citation: Gut. 1997 Mar;40(3):297-301
references.pmid: 9135515
references.citation: APMIS. 2003 Jun;111(6):619-24
references.pmid: 12969017
references.citation: Gut. 1999 Aug;45(2):181-5
references.pmid: 10403728