Low-Positive Antibody Titer against Helicobacter pylori Cytotoxin-Associated Gene A (CagA) May Predict Future Gastric Cancer Better Than Simple Seropositivity against H. pylori CagA or against H. pylori
Low-Positive Antibody Titer against Helicobacter pylori Cytotoxin-Associated Gene A (CagA) May Predict Future Gastric Cancer Better Than Simple Seropositivity against H. pylori CagA or against H. pylori
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DOI：
10.1158/1055-9965.epi-06-1048
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发表时间：
2007-06
影响因子：
3.8
通讯作者：
G. Suzuki;H. Cullings;S. Fujiwara;N. Hattori;Shinsuke Matsuura;M. Hakoda;M. Akahoshi;K. Kodama;E. Tahara
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文献类型：
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作者：
G. Suzuki;H. Cullings;S. Fujiwara;N. Hattori;Shinsuke Matsuura;M. Hakoda;M. Akahoshi;K. Kodama;E. Tahara
背景：探讨抗幽门螺杆菌CagA抗体滴度与非贲门癌发生的关系。方法：采用嵌套病例对照研究方法，对原子弹幸存者诊断前(平均2.3年)保存血清进行纵向队列研究。从年龄、性别、城市、血清储存时间和类型匹配、辐射剂量相反的队列成员中选择299例癌症病例和每个病例3名对照。结果：幽门螺杆菌抗体阳性伴CagAIg G低滴度是非贲门型胃癌的最大危险因素[相对危险度(RR)，3.9；95%可信区间(95%CI)，2.1~7.0；P<0.001]，尤其是肠型肿瘤(RR，9.9，95%CI，3.5~2 7.4；P<0.001)。P=0.0052)、幽门螺杆菌Ig G高滴度阳性(RR，2.0；95%CI，1.3-3.2；P=0.0022)、慢性萎缩性胃炎(RR，2.4；95%CI，1.8-3.3；P<0.0 1)、现在吸烟(RR，2.3；95%CI，1.4-3.5；P<；0.001)或辐射剂量(RR，2.1；95%CI，1.2-3.1；P=0.00193)。目前吸烟的患者患弥漫型肿瘤的风险显著高于肠型肿瘤(P=0.0372)。辐射风险仅对非吸烟者、所有非贲门癌和弥漫型胃癌有显著意义。结论：低CagA免疫球蛋白滴度是识别高危人群的有用生物标志物，也为了解宿主-病原体相互作用提供了线索。(癌症流行病学生物标记物2007；16(6)：1224-8)
Background: To investigate the IgG antibody titer against Helicobacter pylori CagA as a risk factor for future noncardia gastric cancer. Methods: A nested case-control study was done in the longitudinal cohort of atomic bomb survivors using stored sera before diagnosis (mean, 2.3 years). Enrolled were 299 cancer cases and 3 controls per case selected from cohort members matched on age, gender, city, and time and type of serum storage and countermatched on radiation dose. Results: H. pylori IgG seropositive with CagA IgG low titer was the strongest risk factor for noncardia gastric cancer [relative risk (RR), 3.9; 95% confidence interval (95% CI), 2.1-7.0; P < 0.001], especially for intestinal-type tumor (RR, 9.9, 95% CI, 3.5-27.4; P < 0.001), compared with other risk factors, H. pylori IgG seropositive with CagA IgG negative (RR, 2.2; 95% CI, 1.3-3.9; P = 0.0052), H. pylori IgG seropositive with CagA IgG high titer (RR, 2.0; 95% CI, 1.3-3.2; P = 0.0022), chronic atrophic gastritis (RR, 2.4; 95% CI, 1.8-3.3; P < 0.001), current smoking (RR, 2.3; 95% CI, 1.4-3.5; P < 0.001), or radiation dose (RR, 2.1; 95% CI, 1.2-3.1; P = 0.00193). Current smoking showed significantly higher risk for diffuse-type than intestinal-type tumors (P = 0.0372). Radiation risk was significant only for nonsmokers, all noncardia, and diffuse-type gastric cancers. Conclusions: A low CagA IgG titer is a useful biomarker to identify a high-risk group and it also provides a clue to understanding host-pathogen interaction. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1224–8)