Is there an association between Helicobacter pylori cytotoxin Cag A seropositivity and risk for gastric cancer?

Abstract:

BACKGROUND:Since discovered in 1990, Cag A, a protein expressed by specific strains of Helicobacter pylori, was thought able to explain why only a few Helicobacter infected patients develop peptic diseases and gastric cancer. However, clinical trials provide discordant results. MATERIALS AND METHODS:In this study we evaluate Helicobacter pylori and Cag A seropositivity in 35 cancer affected patients, in 36 gastritis affected patients and in 40 healthy blood donors by means of two commercially available fluorescence enzyme-immunoessay (ELISA). RESULTS:Odds ratios determination strongly suggests that Cag A bearer Helicobacter strains play a pathogenetic role in gastric diseases (OR 4.23, 95% CI 3.22-5.24 for cancer versus healthy volunteers, OR 3.2, 95% CI 2.19-4.21 for gastritis versus asymptomatic patients), but is unable to demonstrate a direct carcinogenic activity (cancer-gastritis difference is not significant: OR 1.32, 95% CI 0.39-1.25). CONCLUSIONS:Cag A seropositivity can be considered a risk factor for peptic disease, and only indirectly for gastric carcinoma. The paper also discuss some sampling, laboratory and statistical bias that can explain a wide eterogenity of the results reported in the literature.

journal_name

Ann Ital Chir

authors

Baiocchi GL,Vettoretto N,Colombrita D,Giovanetti M,Coniglio A,Bonardelli S,Pelizzari A,Ronconi M,Tiberio GA,Giulini SM

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

571-6; discussion 577-8

issue

6

eissn

0003-469X

issn

2239-253X

journal_volume

73

pub_type

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