title: Helicobacter pylori infection and fundic gastric atrophy are not associated with esophageal squamous cell carcinoma: a case-control study.
abstract: OBJECTIVE
  Recent studies from Asia and Northern Europe suggest that apart from alcohol intake and smoking, fundic gastric atrophy (FGA) may also increase the risk of esophageal squamous cell carcinoma (OSCC). However, because of the wide geographic variation of this cancer and the changing prevalence of the Helicobacter pylori infection, these findings need to be confirmed in other ethnic groups. The aim of this case-control study was to investigate whether H. pylori infection and FGA carry an increased risk for OSCC.
  
  
  METHODS
  FGA was evaluated, by histology and serology, in 75 patients with OSCC, and 75 sex-matched and age-matched controls. Pepsinogen (PG) I levels 70 μg/ml or less and PG I/II ratio of 3 or less were indicative for FGA. H. pylori infection was defined as positivity to at least one test among histology, rapid urease test, and serology for both general anti-IgG and anti-CagA.
  
  
  RESULTS
  Overall, the prevalence of H. pylori infection was identically high (70.7%) in both patients with OSCC and controls. FGA diagnosed by serology and histology was not associated with an increased risk for OSCC [odds ratio (OR)=1.17; 95% confidence interval (CI)=0.54-2.56 and OR=1.91; 95% CI=0.6-5.99, respectively]. ORs (95% CI) for hazardous alcohol consumption, smoking, and the presence of both risk factors were 5.75 (2.20-15.05), 22.18 (9.41-52.28), and 31.69 (8.39-119.67), respectively.
  
  
  CONCLUSIONS
  Hazardous alcohol consumption and smoking increase synergistically the risk for developing OSCC. In our population neither H. pylori infection nor FGA was associated with an increased risk for OSCC.
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany.
authors.forename: Marino
authors.initials: M
authors.lastname: Venerito
authors.forename: Sabine
authors.initials: S
authors.lastname: Kohrs
authors.forename: Thomas
authors.initials: T
authors.lastname: Wex
authors.forename: Daniela
authors.initials: D
authors.lastname: Adolf
authors.forename: Doerthe
authors.initials: D
authors.lastname: Kuester
authors.forename: Daniel
authors.initials: D
authors.lastname: Schubert
authors.forename: Ulrich
authors.initials: U
authors.lastname: Peitz
authors.forename: Klaus
authors.initials: K
authors.lastname: Mönkemüller
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000209:etiology* / Q000382:microbiology; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000209:etiology* / Q000382:microbiology; D005260:Female; D005748:Gastric Fundus; D005757:Gastritis, Atrophic / Q000150:complications* / Q000175:diagnosis; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010435:Pepsinogens / Q000097:blood; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects
chemical_list: D010435:Pepsinogens