title: Prospective study of Helicobacter pylori biomarkers for gastric cancer risk among Chinese men.
abstract: BACKGROUND
  Helicobacter pylori is the leading risk factor for gastric cancer, yet only a fraction of infected individuals ever develop neoplasia.
  
  
  METHODS
  To identify potential predictive biomarkers, we assessed the association of 15 antibodies to H. pylori proteins and gastric cancer in a nested case-control study. Blood levels of antibodies were assessed using multiplex serology for 226 incident cases and 451 matched controls from the Shanghai Men's Health Study. ORs and 95% confidence intervals (CI) were calculated using conditional logistic regression.
  
  
  RESULTS
  Seropositivity to four (Omp, HP0305, HyuA, and HpaA) proteins was associated with a 1.5- to 3-fold increased risk for gastric cancer. When excluding cases diagnosed within 2 years of study enrollment, seropositivity to two additional proteins (CagA and VacA) showed significant associations with risk. Compared with individuals with three or fewer seropositive results to the six virulent proteins identified in this population, individuals with four to five seropositive results were at a 2-fold increased risk (OR, 2.08; 95% CI, 1.31-3.30) and individuals seropositive to all six proteins had a 3.5-fold increase in risk (OR, 3.49; 95% CI, 2.00-6.11) for gastric cancer. Among individuals diagnosed at least 2 years after study enrollment, these associations were even stronger (ORs, 2.79 and 4.16, respectively).
  
  
  CONCLUSIONS
  Increasing number of seropositives to six H. pylori proteins may be a risk marker for distal gastric cancer in China.
  
  
  CONCLUSIONS
  In a population with a 90% prevalence of CagA-positive H. pylori infection, assessment of additional virulent H. pylori proteins might better identify individuals at high risk for gastric cancer.
authors.affiliation: Division of Epidemiology, Vanderbilt University School of Medicine, 2525 West End Avenue, Nashville, TN 37203, USA. eira.epplein@vanderbilt.edu
authors.forename: Meira
authors.initials: M
authors.lastname: Epplein
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Yong-Bing
authors.initials: YB
authors.lastname: Xiang
authors.forename: Richard M
authors.initials: RM
authors.lastname: Peek
authors.forename: Honglan
authors.initials: H
authors.lastname: Li
authors.forename: Pelayo
authors.initials: P
authors.lastname: Correa
authors.forename: Jing
authors.initials: J
authors.lastname: Gao
authors.forename: Angelika
authors.initials: A
authors.lastname: Michel
authors.forename: Michael
authors.initials: M
authors.lastname: Pawlita
authors.forename: Qiuyin
authors.initials: Q
authors.lastname: Cai
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D016481:Helicobacter Infections / Q000097:blood* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000907:Antibodies, Bacterial