title: Characteristics of gastric cancer according to Helicobacter pylori infection status.
abstract: OBJECTIVE
  The definition and incidence of gastric cancer (GC) without Helicobacter pylori (Hp) infection varies between studies. The aim of our study was to compare the characteristics of GC according to Hp infection status.
  
  
  METHODS
  We evaluated the presence of Hp infection in 1833 GC patients with rapid urease tests, serology examinations, and histological evaluations. GC was classified as GC with current Hp infection (HpC-GC), GC with past Hp infection (HpP-GC), and GC not associated with Hp infection (HpN-GC). HpP-GC was defined as GC without current infection but with a positive serology test, glandular atrophy, and/or intestinal metaplasia. HpN-GC was defined as GC with negative Hp test results and no histological changes.
  
  
  RESULTS
  The numbers of HpC-GC, HpP-GC, and HpN-GC were 1378 (75.2%), 412 (22.5%), and 43 (2.3%), respectively. Among GCs without current infection, 90.5% (412/455) were associated with HpP-GC. HpP-GCs were more common in older and male patients, had an increased incidence of synchronous cancer, and less frequently had a diffuse-type histology than HpC-GCs. HpN-GCs were more common in younger, female patients; had a higher proportion of diffuse-type cancers; and more frequently showed distant metastasis than HpP-GCs. In the 40s, the proportion of HpP-GCs with diffuse-type histology (41.9%) was lower than that of HpC-GCs (60.3%) (P = 0.016). The difference was also significant in the 50s (29.1% vs 40.1%, respectively, P = 0.004).
  
  
  CONCLUSIONS
  Most GCs in Korea without current Hp infection showed evidence of past Hp infection. The proportion of GCs with diffuse-type histology decreased in patients with past infection.
authors.affiliation: Center for Gastric Cancer, National Cancer Center, Gyeonggi, Korea.
authors.forename: Hee-Won
authors.initials: HW
authors.lastname: Kwak
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Cho
authors.forename: Jong Yeul
authors.initials: JY
authors.lastname: Lee
authors.forename: Chan Gyoo
authors.initials: CG
authors.lastname: Kim
authors.forename: Myeong-Cherl
authors.initials: MC
authors.lastname: Kook
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D005756:Gastritis / Q000453:epidemiology* / Q000382:microbiology*; D016481:Helicobacter Infections; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000473:pathology
keywords: Helicobacter pylori; atrophy; gastric cancer; intestinal metaplasia