Meta-analysis of the relationship between cagA seropositivity and gastric cancer
Meta-analysis of the relationship between cagA seropositivity and gastric cancer
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DOI：
10.1053/j.gastro.2003.08.033
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发表时间：
2003-12-01
期刊：
影响因子：
29.4
通讯作者：
Hunt, RH
中科院分区：
文献类型：
--
作者：
Huang, JQ;Zheng, GF;Hunt, RH
背景和目标：关于幽门螺杆菌cagA阳性菌株感染与胃癌关系的文献报道超过了H。pylori感染本身是相互矛盾的。本研究的目的是评估与cagA血清阳性相关的胃癌风险的大小，并确定研究之间异质性的任何来源。方法：对年龄和性别匹配的病例对照研究进行荟萃分析，这些研究提供了H。pylori和cagA菌株。pylori，通过血清学或聚合酶链反应DNA检测。结果：全面的文献检索确定了16个合格的研究，2284例和2770对照。H. pylori和cagA血清阳性分别使胃癌风险显着增加2.28和2.87倍。在H.在幽门螺杆菌感染人群中，cagA阳性菌株感染进一步增加了胃癌的风险，总体增加了1.64倍（95%置信区间[CI]，1.21-2.24），非贲门胃癌增加了2.01倍（95% CI，1.21-3.32）。贲门部胃癌与H. pylori感染或cagA阳性H.幽门。患者年龄和胃癌部位导致研究间的异质性。结论：cagA阳性H.幽门螺杆菌增加胃癌的风险超过与H. pylori感染。在H上搜索cagA状态。幽门螺杆菌感染可能在识别胃癌高危人群中提供额外的益处。
Background & Aims: Reports in the literature regarding the relationship of infection with cagA-positive strains of Helicobacter pylori to gastric cancer over and above H. pylori infection alone are conflicting. The aim of this study was to estimate the magnitude of the risk for gastric cancer associated with cagA seropositivity and to identify any sources of heterogeneity between studies. Methods: A meta-analysis of case-control studies with age- and sex-matched controls, which provided raw data on the infection rates with H. pylori and cagA strains of H. pylori as detected by serology or polymerase chain reaction DNA, was performed. Results: A comprehensive literature search identified 16 qualified studies with 2284 cases and 2770 controls. H. pylori and cagA seropositivity significantly increased the risk for gastric cancer by 2.28- and 2.87-fold, respectively. Among H. pylori-infected populations, infection with cagA-positive strains further increased the risk for gastric cancer by 1.64-fold (95% confidence interval [CI], 1.21-2.24) overall and by 2.01-fold (95% CI, 1.21-3.32) for noncardia gastric cancer. Gastric cancer at the cardia is not associated with H. pylori infection or cagA-positive strains of H. pylori. Patient age and site of gastric cancer contributed to the heterogeneity between studies. Conclusions: Infection with cagA-positive strains of H. pylori increases the risk for gastric cancer over the risk associated with H. pylori infection alone. Searching for cagA status over H. pylori infection may confer additional benefit in identifying populations at greater risk for gastric cancer.