title: Familial Clustering of Gastric Cancer: A Retrospective Study Based on the Number of First-Degree Relatives.
abstract: This comprehensive cross-sectional study aimed to identify factors contributing to familial aggregation of gastric cancer (GC). A total of 1058 GC patients and 1268 controls were analyzed separately according to the presence or absence of a first-degree relative of GC (GC-relative). Logistic regression analysis adjusted for age, gender, residence during childhood, smoking, alcohol intake, monthly income, spicy food ingestion, Helicobacter pylori status and host cytokine polymorphisms was performed. Cytotoxin-associated gene A (cagA) positivity was a distinctive risk factor for GC in the family history (FH)-positive group (odds ratio [OR], 2.39; 95% confidence interval [CI], 1.42-4.00), while current/ex-smoker, moderate to strong spicy food ingestion, and non-B blood types were more closely associated with GC in the FH-negative group. Among the FH-positive group, alcohol consumption showed a synergistic carcinogenic effect in the at least 2 GC-relatives group compared to the 1 GC-relative group (1.71 vs. 9.58, P for interaction = 0.026), and this was dose-dependent. In the subjects with ≥2 GC-relatives, TGFB1-509T/T was a risk factor for GC (OR 23.74; 95% CI 1.37-410.91), as were rural residency in childhood, alcohol consumption, spicy food ingestion, and cagA positivity. These results suggest that subjects with FH may be a heterogeneous group in terms of gastric cancer susceptibility. Especially, subjects with ≥2 GC-relatives should undergo risk stratification including TGFB1-509T/T and alcohol consumption.
authors.affiliation: From the Department of Internal Medicine (YJC, NK, CMS and DHL), Seoul National University Bundang Hospital, Seongnam; Department of Internal Medicine and Liver Research Institute (NK, SO, DHL and HCJ), Seoul National University College of Medicine; and Department of Statistics (WJ, BS), College of Science, Seoul National University, Seoul, South Korea.
authors.forename: Yoon Jin
authors.initials: YJ
authors.lastname: Choi
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.forename: Woncheol
authors.initials: W
authors.lastname: Jang
authors.forename: Bochang
authors.initials: B
authors.lastname: Seo
authors.forename: Sooyeon
authors.initials: S
authors.lastname: Oh
authors.forename: Cheol Min
authors.initials: CM
authors.lastname: Shin
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000942:Antigens, Bacterial / Q000032:analysis; D001426:Bacterial Proteins / Q000032:analysis; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004032:Diet; D005190:Family; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000378:metabolism; D006801:Humans; D007182:Income; D008297:Male; D008679:Metaplasia / Q000453:epidemiology; D008875:Middle Aged; D010375:Pedigree; D011706:Pyloric Antrum / Q000473:pathology*; D056910:Republic of Korea / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000235:genetics* / Q000382:microbiology; D053773:Transforming Growth Factor beta1 / Q000235:genetics
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C508960:TGFB1 protein, human; D053773:Transforming Growth Factor beta1; C080866:cagA protein, Helicobacter pylori