title: Seroprevalence of Helicobacter pylori infection and gastric mucosal atrophy in Bhutan, a country with a high prevalence of gastric cancer.
abstract: Gastric cancer is the second leading cause of cancer-related mortality in the world. Recently, serum Helicobacter pylori antibodies and pepsinogen (PG) have been used for gastric cancer screening. The incidence of gastric cancer in Bhutan is reported to be quite high compared with that in neighbouring countries. In this study, 381 subjects from three areas of Bhutan were assessed for gastric mucosal atrophy and serological parameters. Anti-H. pylori IgG, PG I, PG II and cytotoxin-associated gene A (CagA) antibodies were measured using ELISA. Subjects were classified into four groups according to H. pylori and PG seropositivity: Group A (H. pylori-negative/PG-negative), Group B (H. pylori-positive/PG-negative), Group C (H. pylori-positive/PG-positive) and Group D (H. pylori-negative/PG-positive). The prevalence of H. pylori in the 381 subjects was 71.1% (271/381), with high infection rates found in rural areas. The PG I/II ratio was significantly inversely correlated with the atrophy score in the antrum and the corpus (P<0.001). Multivariate analysis showed that the PG status was significantly associated with the presence of atrophy in the corpus. The prevalence of the PG-positive status was significantly higher among H. pylori-positive subjects than among H. pylori-negative subjects (P<0.001). Based on the ABC method, Group B was the most dominant, followed by Group A, Group C and Group D. The high incidence of gastric cancer in Bhutan can be attributed to the high prevalence of H. pylori infection and gastric mucosal atrophy.
authors.affiliation: Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Shiota
authors.affiliation: GI and Liver Center, Bangkok Medical Center, Bangkok, Thailand.
authors.forename: Varocha
authors.initials: V
authors.lastname: Mahachai
authors.affiliation: Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand.
authors.forename: Ratha-Korn
authors.initials: RK
authors.lastname: Vilaichone
authors.affiliation: Department of Surgery, Rajavithi Hospital, Bangkok, Thailand.
authors.forename: Thawee
authors.initials: T
authors.lastname: Ratanachu-Ek
authors.affiliation: Department of Surgery, Jigme Dorji Wangchuk National Referral Hospital, Thimphu, Bhutan.
authors.forename: Lotay
authors.initials: L
authors.lastname: Tshering
authors.affiliation: Department of Molecular Pathology, Oita University Faculty of Medicine, Yufu, Japan.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Department of Gastroenterology, Oita University Faculty of Medicine, Yufu, Japan.|Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsunari
authors.affiliation: Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USA.|Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamaoka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D001284:Atrophy / Q000453:epidemiology*; D001631:Bhutan / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D016481:Helicobacter Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020116:Pepsinogen A / Q000097:blood; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D020116:Pepsinogen A