title: Helicobacter pylori with stronger intensity of CagA phosphorylation lead to an increased risk of gastric intestinal metaplasia and cancer.
abstract: BACKGROUND
  Nearly all Taiwanese H. pylori stains are cagA-genopositive and encode CagA protein. In this study, we evaluated whether different intensity of tyrosine phosphorylated-CagA (p-CagA) had an impact on the clinical diseases and histological outcomes in this area.
  
  
  RESULTS
  We enrolled 469 dyspeptic patients and prospectively obtained the gastric biopsy specimens and the H. pylori isolates. These patients were categorized according to the clinical diseases, such as duodenal ulcer, gastric ulcer, gastric cancer, and gastritis with or without intestinal metaplasia. Their gastric specimens were reviewed by the updated Sydney's system. Furthermore, a total of 146 patients were randomly selected from each clinical category for evaluation of their isolates' p-CagA intensity by in vitro AGS cells co-culture. The p-CagA was sparse in 30 (20.5%), weak in 59 (40.5%), and strong in 57 (39%) isolates. The isolates from the patients of gastric cancer or gastritis with intestinal metaplasia had stronger p-CagA intensity than those of gastritis without intestinal metaplasia (p ≤ 0.002). Moreover, the patients infected with isolates with strong or weak p-CagA intensity had a higher risk of gastric intestinal metaplasia (p < 0.05, odds ratio 3.09~15.26) than those infected with sparse p-CagA isolates.
  
  
  CONCLUSIONS
  Infection with H. pylori stains with stronger p-CagA intensity may lead to an increased risk of gastric intestinal metaplasia and cancer.
authors: Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan.
authors: Chiao-Hsiung
authors: CH
authors: Chuang
authors: Hsiao-Bai
authors: HB
authors: Yang
authors: Shew-Meei
authors: SM
authors: Sheu
authors: Kuei-Hsiang
authors: KH
authors: Hung
authors: Jiunn-Jong
authors: JJ
authors: Wu
authors: Hsiu-Chi
authors: HC
authors: Cheng
authors: Wei-Lun
authors: WL
authors: Chang
authors: Bor-Shyang
authors: BS
authors: Sheu
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