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Ann Ital Chir. 2002 Nov-Dec;73(6):571-6; discussion 577-8.

Is there an association between Helicobacter pylori cytotoxin Cag A seropositivity and risk for gastric cancer?

Author information

1
Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, Italy.

Abstract

BACKGROUND:

Since discovered in 1990, Cag A, a protein expressed by specific strains of Helicobacter pylori, was thought able to explain why only a few Helicobacter infected patients develop peptic diseases and gastric cancer. However, clinical trials provide discordant results.

MATERIALS AND METHODS:

In this study we evaluate Helicobacter pylori and Cag A seropositivity in 35 cancer affected patients, in 36 gastritis affected patients and in 40 healthy blood donors by means of two commercially available fluorescence enzyme-immunoessay (ELISA).

RESULTS:

Odds ratios determination strongly suggests that Cag A bearer Helicobacter strains play a pathogenetic role in gastric diseases (OR 4.23, 95% CI 3.22-5.24 for cancer versus healthy volunteers, OR 3.2, 95% CI 2.19-4.21 for gastritis versus asymptomatic patients), but is unable to demonstrate a direct carcinogenic activity (cancer-gastritis difference is not significant: OR 1.32, 95% CI 0.39-1.25).

CONCLUSIONS:

Cag A seropositivity can be considered a risk factor for peptic disease, and only indirectly for gastric carcinoma. The paper also discuss some sampling, laboratory and statistical bias that can explain a wide eterogenity of the results reported in the literature.

PMID:
12820580
[Indexed for MEDLINE]

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