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Helicobacter pylori in gastric cancer established by CagA immunoblot as a marker of past infection.
Ekström, A M; Held, M; Hansson, L E; Engstrand, L; Nyrén, O.
Afiliación
  • Ekström AM; Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. Anna.Mia.Ekstrom@phs.ki.se
Gastroenterology ; 121(4): 784-91, 2001 Oct.
Article en En | MEDLINE | ID: mdl-11606491
BACKGROUND & AIMS: Helicobacter pylori may disappear spontaneously with progressing precancerous changes and invalidate serologic studies of its association with gastric cancer. We reestimated the strength of the H. pylori-gastric cancer relationship, using both conventional immunoglobulin (Ig) G enzyme-linked immunosorbent assay (ELISA) and immunoblot (against cytotoxin-associated antigen A [CagA] antibodies that prevail longer after eradication) to detect past H. pylori exposure more relevant for time at cancer initiation. METHODS: In our population-based case-control study, the seroprevalence among 298 gastric adenocarcinoma cases was 72% (IgG ELISA) and 91% (immunoblot) vs. 55% and 56% among 244 controls frequency-matched for age and gender. RESULTS: Using IgG ELISA only, the adjusted OR for noncardia gastric cancer among H. pylori-positive subjects was 2.2 (95% confidence interval [CI], 1.4-3.6). When ELISA-/CagA+ subjects (odds ratio [OR], 68.0) were removed from the reference, the OR rose to 21.0 (95% CI, 8.3-53.4) and the previous effect modification by age disappeared. ELISA+/CagA- subjects had an OR of 5.0 (95% CI, 1.1-23.6). There were no associations with cardia cancer. CONCLUSIONS: The weaker H. pylori-cancer relationships in studies based on IgG ELISA rather than CagA may be caused by misclassification of relevant exposure. A much stronger relationship emerges with more accurate exposure classification. In the general Swedish population, 71% of noncardia adenocarcinomas were attributable to H. pylori.
Asunto(s)
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Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Proteínas Bacterianas / Adenocarcinoma / Helicobacter pylori / Infecciones por Helicobacter / Antígenos Bacterianos Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Europa Idioma: En Revista: Gastroenterology Año: 2001 Tipo del documento: Article País de afiliación: Suecia
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Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Proteínas Bacterianas / Adenocarcinoma / Helicobacter pylori / Infecciones por Helicobacter / Antígenos Bacterianos Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: Europa Idioma: En Revista: Gastroenterology Año: 2001 Tipo del documento: Article País de afiliación: Suecia