Infection with Helicobacter pylori strains possessing cagA is associated with an increased risk of developing adenocarcinoma of the stomach.
Infection with Helicobacter pylori strains possessing cagA is associated with an increased risk of developing adenocarcinoma of the stomach.
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发表时间：
1995-05
期刊：
影响因子：
11.2
通讯作者：
M. Blaser;G. Perez-Perez-G.-Perez-Perez-82101131;H. Kleanthous;T. Cover;R. Peek;P. Chyou;G. Stemmermann;A. Nomura
中科院分区：
文献类型：
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作者：
M. Blaser;G. Perez-Perez-G.-Perez-Perez-82101131;H. Kleanthous;T. Cover;R. Peek;P. Chyou;G. Stemmermann;A. Nomura
为了确定是否感染具有cagA的幽门螺杆菌菌株与胃腺癌发生风险增加有关，我们采用了一项巢式病例对照研究，该研究基于夏威夷奥肯的5443名日裔美国男性，他们在1967年至1970年期间进行了体格检查和静脉切开术。我们匹配了103 H.幽门螺杆菌感染的男性在21年的103 H.幽门螺杆菌感染的男性，他们没有发展成胃癌，并检测了储存的患者和对照血清标本中是否存在H. pylori使用ELISA。使用重组CagA片段的血清IgG测定在临床定义的人群中使用时具有94.4%的灵敏度和92.5%的特异性;血清学结果稳定超过7年。对于携带CagA抗体的男性，发生胃癌的比值比为1.9（95%置信区间，0.9 - 4.0）;对于远端胃的肠型癌症，比值比为2.3（95%置信区间，1.0 - 5.2）。年龄<72岁和诊断时的晚期肿瘤分期与CagA血清阳性显著相关。我们的结论是，感染cagA阳性H。pylori菌株与cagA阴性菌株相比，在一定程度上增加了胃癌发展的风险，尤其是影响远端胃的肠型胃癌。
To determine whether infection with a Helicobacter pylori strain possessing cagA is associated with an increased risk of development of adenocarcinoma of the stomach, we used a nested case-control study based on a cohort of 5443 Japanese-American men in Oahu, Hawaii, who had a physical examination and a phlebotomy during 1967 to 1970. We matched 103 H. pylori-infected men who developed gastric cancer during a 21-year surveillence period with 103 H. pylori-infected men who did not develop gastric cancer and tested stored serum specimens from patients and controls for the presence of serum IgG to the cagA product of H. pylori using an ELISA. The serum IgG assay using a recombinant CagA fragment had a sensitivity of 94.4% and a specificity of 92.5% when used in a clinically defined population; serological results were stable for more than 7 years. For men with antibodies to CagA, the odds ratio of developing gastric cancer was 1.9 (95% confidence interval, 0.9-4.0); for intestinal type cancer of the distal stomach, the odds ratio was 2.3 (95% confidence interval, 1.0-5.2). Age < 72 years and advanced tumor stage at diagnosis were significantly associated with CagA seropositivity. We conclude that infection with a cagA-positive H. pylori strain in comparison with a cagA-negative strain somewhat increases the risk for development of gastric cancer, especially intestinal type affecting the distal stomach.