Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection
Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection
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DOI：
10.1136/gut.40.3.297
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发表时间：
1997-03-01
期刊：
影响因子：
24.5
通讯作者：
Vogelman, H
中科院分区：
文献类型：
--
作者：
Parsonnet, J;Friedman, GD;Vogelman, H
背景和目的--目前尚不清楚为什么一些幽门螺杆菌感染的人会患上胃癌，而另一些人则不会。评估Hp感染的CagA表型是否独立于其他假定的危险因素影响患癌症的风险。受试者-242名参与先前胃癌嵌套病例对照研究的人。采用酶联免疫吸附试验(EL ISA)检测了179例(90例患者和89例正常对照)血清中Hp感染，63例(13例患者和50例正常对照)未感染Hp。方法：对确诊前平均14.2年的病例和对照血清标本，用酶联免疫吸附试验检测Hp CagA基因产物的Ig G抗体，用Logistic回归分析比较CagA抗体阳性者、CagA抗体阴性者、结果：携带CagA抗体的幽门螺杆菌感染者发生胃癌的几率是未感染者的5.8倍(95%可信区间(95%CI)=2.6~13.0)。无论是肠癌(优势比(OR)5.1，95%CI=2.1-12.2)还是弥漫型(OR 10.1，95%CI=2.2-47.4)都是如此。相比之下，没有CagA抗体的Hp感染者患癌症的风险仅有轻微增加，且不显著(OR2.2，95%CI=0.9-5.4)，任何可能的关联仅限于弥漫型癌(OR 9.0，95%CI=1.2-65.8)。胃蛋白酶原1
Background and aims-It is not known why some people with Helicobacter pylori infection develop gastric cancer whereas others do not. Whether the CagA phenotype of H pylori infection affected risk for cancer independently of other posited risk factors was evaluated.Subjects-242 persons who participated in a previous nested case-control study of gastric cancer. 179 (90 cases and 89 controls) were infected with H pylori as determined by enzyme linked immunosorbent assay (ELISA) in serum and 63 (13 cases and 50 controls) were uninfected.Methods-Serum samples from cases and controls, obtained a mean of 14.2 years before diagnosis of cancer in the cases, were tested by ELISA for IgG antibodies against the CagA gene product of H pylori, They had previously been tested for pepsinogen I. Using logistic regression analysis, risk for cancer was compared among infected persons with CagA antibodies, infected persons without CagA antibodies, and uninfected persons.Results-Subjects infected with H pylori who had CagA antibodies were 5.8-fold more likely than uninfected subjects to develop gastric cancer (95% confidence interval (95% CI)=2.6-13.0). This was true for both intestinal (odds ratio (OR) 5.1, 95% CI=2.1-12.2) and diffuse type (OR 10.1, 95% CI=2.2-47.4) cancers. By contrast, H pylori infected subjects without CagA antibodies were only slightly, and not significantly, at increased risk for cancer (OR 2.2, 95% CI=0.9-5.4) and any possible association was restricted to diffuse type carcinoma (OR 9.0, 95% CI=1.2-65.8). Pepsinogen 1