New strategies for the prevention of gastric cancer: Helicobacter pylori and genetic susceptibility.
Recently acquired knowledge points to the potential of markedly improved strategies for the prevention of gastric cancer. The International Agency for Cancer Research has reached the conclusion that infection with Helicobacter pylori (H. pylori) is carcinogenic to humans (Group I). The bacterium displays marked genetic heterogeneity. Virulence related genes, especially cag A and vac A s1 m1 are associated with an increased cancer risk. Genetic susceptibility, especially polymorphisms of the cytokine genes may increase cancer risk. Highly susceptible individuals infected with high virulence bacterial genotypes have a markedly increased gastric cancer risk. They should be targeted for endoscopic monitoring to detect advanced precancerous lesions. The state of the art is briefly reviewed and the needed research identified.
Correa
Pelayo
P
Department of Pathology, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA. correa@lsuhsc.edu
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics; D016207:Cytokines / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D005838:Genotype; D016481:Helicobacter Infections / Q000188:drug therapy / Q000235:genetics*; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D011110:Polymorphism, Genetic; D011230:Precancerous Conditions / Q000188:drug therapy; D012307:Risk Factors; D012643:Selenium / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000517:prevention & control*; D014774:Virulence; D014810:Vitamin E / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D016207:Cytokines; C074689:VacA protein, Helicobacter pylori; C080866:cagA protein, Helicobacter pylori; D014810:Vitamin E; D012643:Selenium