[Serological assessment of Helicobacter pylori-specific antibodies and their association with gastric lesions in a high-risk population].

OBJECTIVE: To determine the distributions of six Helicobacter pylori (Hp)-specific antibodies in a high-risk population of gastric cancer (GC) and explore the relationship between Hp virulence factors and precancerous gastric lesions. METHODS: Based on the two intervention trials conducted in Linqu County, the seropositivities for CagA, VacA, GroEL, UreA, HcpC and GGT were assessed by recombinant immunoassay (recomLine) in 623 participants with H. pylori infection determined by (13)C-urea breath test ((13)C-UBT) and/or enzyme linked immunosorbent assay (ELISA). RESULTS: In a total of 623 participants were detected by recomLine analysis, of which 594 were Hp-positive. The seropositivities rates of CagA, VacA, GroEL, UreA, HcpC and GGT were 84.0%, 38.2%, 66.7%, 17.7%, 58.8% and 42.8%, respectively. A total of 523 participants were determined as type I infection of Hp, accounting for 88.1%. Compared with superficial gastritis (SG), the infection rate of Hp type I was higher in the chronic atrophic gastritis (CAG) (P = 0.001). CONCLUSIONS: The results of this population-based study suggest that the virulence factors of Hp may be related to the development of GC in a Chinese high-risk population. The recomLine analysis may serve as a tool for identification of Hp strains and prediction of high-risk population of GC.

Epidemiological and economic impact of human papillomavirus vaccines.

BACKGROUND: Despite screening, cervical cancer (CC) remains a serious health care problem. Because human papillomavirus (HPV) is the necessary cause of CC, the development of 2 new vaccines can have a tremendous impact on CC and other HPV-related conditions. In this systematic review, the epidemiological and economic impacts of HPV are evaluated. METHODS: A literature search was conducted through MEDLINE, Web of Science, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature. Articles were selected based on inclusion and exclusion criteria. Economic evaluations were submitted to a quality assessment. RESULTS: Sixteen articles were selected to review the epidemiological impact of HPV vaccines, and 11 were selected to review the economic impact. The studies were very heterogeneous because of different assumptions. Nevertheless, a substantial reduction in CC is reported consistently and a (smaller) reduction in precancerous lesions and HPV prevalence. Cost-effectiveness ratios are also very diverse and dependent on the assumptions made. An HPV vaccine can be profitable if duration of vaccine-related immunity is high, efficacy is high, price is low, screening is reduced, administration is before sexual activity, discount rate is not too high, or if there is herd immunity. CONCLUSIONS: Human papillomavirus vaccines have the potential to reduce CC by at least approximately half of its current incidence, and this might be cost-effective if there is high efficacy with a long-lasting immunity.

Assessment of proliferating cell nuclear antigen expression in precursor stages of gastric carcinoma using the PC10 antibody to PCNA.

Immunohistochemistry using the PC10 antibody to proliferating cell nuclear antigen (PCNA) was applied to archival material from mucosa adjacent to gastric carcinoma ('normal', hyperplasia, complete and incomplete intestinal metaplasia and dysplasia) and non-cancer controls (normal and complete intestinal metaplasia). Overall, increased PCNA indices, with expansion and altered location of the proliferative zones, were observed in carcinoma fields and compared with controls (P < 0.001). These differences were particularly significant in 'normal' mucosa far from carcinoma as compared with normal in controls (P < 0.001). In carcinoma 'fields' distinct patterns of PCNA expression were noted in complete and incomplete intestinal metaplasia. Similarly, in dysplastic lesions high PCNA indices were present either throughout the gland or found predominantly in the upper compartment. We conclude that these differences in PCNA index and staining patterns might prove useful in monitoring the evolution of the disease in the follow-up of patients at risk of developing gastric cancer.