title: Evaluation of the Pattern of EPIYA Motifs in the Helicobacter pylori cagA Gene of Patients with Gastritis and Gastric Adenocarcinoma from the Brazilian Amazon Region.
abstract: The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92-7.46, and P = 0.002). A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation.
authors.affiliation: Laboratório de Patologia Clínica, Núcleo de Medicina Tropical, Universidade Federal do Pará, Avenida Generalissimo Deodoro No. 92, Umarizal, 66095-360 Belém, PA, Brazil.
authors.forename: Adenielson
authors.initials: A
authors.lastname: Vilar E Silva
authors.affiliation: Laboratório de Patologia Clínica, Núcleo de Medicina Tropical, Universidade Federal do Pará, Avenida Generalissimo Deodoro No. 92, Umarizal, 66095-360 Belém, PA, Brazil; Núcleo de Medicina Tropical, Laboratório de Patologia Clínica das Doênças Tropicais, Universidade Federal do Pará, Belém, PA, Brazil.
authors.forename: Mario Ribeiro da Silva
authors.initials: MR
authors.lastname: Junior
authors.affiliation: Departamento de Gastroenterologia, Hospital Ophir Loyola, Belém, PA, Brazil.
authors.forename: Ruth Maria Dias Ferreira
authors.initials: RM
authors.lastname: Vinagre
authors.affiliation: Laboratório de Patologia Clínica, Núcleo de Medicina Tropical, Universidade Federal do Pará, Avenida Generalissimo Deodoro No. 92, Umarizal, 66095-360 Belém, PA, Brazil; Núcleo de Medicina Tropical, Laboratório de Patologia Clínica das Doênças Tropicais, Universidade Federal do Pará, Belém, PA, Brazil.
authors.forename: Kemper Nunes
authors.initials: KN
authors.lastname: Santos
authors.affiliation: Laboratório de Patologia Clínica, Núcleo de Medicina Tropical, Universidade Federal do Pará, Avenida Generalissimo Deodoro No. 92, Umarizal, 66095-360 Belém, PA, Brazil; Núcleo de Medicina Tropical, Laboratório de Patologia Clínica das Doênças Tropicais, Universidade Federal do Pará, Belém, PA, Brazil.
authors.forename: Renata Aparecida Andrade
authors.initials: RA
authors.lastname: da Costa
authors.affiliation: Laboratório de Patologia Clínica, Núcleo de Medicina Tropical, Universidade Federal do Pará, Avenida Generalissimo Deodoro No. 92, Umarizal, 66095-360 Belém, PA, Brazil; Núcleo de Medicina Tropical, Laboratório de Patologia Clínica das Doênças Tropicais, Universidade Federal do Pará, Belém, PA, Brazil.
authors.forename: Amanda Alves
authors.initials: AA
authors.lastname: Fecury
authors.affiliation: Laboratório de Patologia Clínica, Núcleo de Medicina Tropical, Universidade Federal do Pará, Avenida Generalissimo Deodoro No. 92, Umarizal, 66095-360 Belém, PA, Brazil; Núcleo de Medicina Tropical, Laboratório de Patologia Clínica das Doênças Tropicais, Universidade Federal do Pará, Belém, PA, Brazil.
authors.forename: Juarez Antônio Simões
authors.initials: JA
authors.lastname: Quaresma
authors.affiliation: Laboratório de Patologia Clínica, Núcleo de Medicina Tropical, Universidade Federal do Pará, Avenida Generalissimo Deodoro No. 92, Umarizal, 66095-360 Belém, PA, Brazil; Núcleo de Medicina Tropical, Laboratório de Patologia Clínica das Doênças Tropicais, Universidade Federal do Pará, Belém, PA, Brazil.
authors.forename: Luisa Caricio
authors.initials: LC
authors.lastname: Martins