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Cancer Epidemiol Biomarkers Prev. 2019 Sep 9. pii: cebp.0512.2019. doi: 10.1158/1055-9965.EPI-19-0512. [Epub ahead of print]

Serologic profile of anti-Parietal cell antibodies, pepsinogens and H. pylori and risk of upper gastrointestinal cancer: a nested case-control study in China.

Author information

1
Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
2
Laboratory of Pathology, National Cancer Institute.
3
Division of Cancer Epidemiology & Genetics, National Cancer Institute.
4
Department of Cancer Epidemiology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College.
5
Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute.
6
Dept. of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer,Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
7
Division of Cancer Epidemiology & Genetics, National Cancer Institute abnetc@mail.nih.gov.

Abstract

BACKGROUND:

Autoimmune gastritis is understudied and possibly associated with gastric non-cardia adenocarcinoma (GNCA) and esophageal squamous cell carcinoma (ESCC) in western populations when it presents as pernicious anemia.

METHODS:

A nested case-control study within a Chinese cohort including 100 ESCC, 200 gastric cardia adenocarcinoma (GCA), and 200 GNCA cases diagnosed between 1986 and 2001 and 400 controls. Serostatus of anti-Parietal cell antibodies (APCA), H. pylori antibodies, and pepsinogens were measured using commercial kits and serum collected at baseline. We used logistic regression to calculate odds ratios (OR) and 95% confidence interval (CI) for associations between serologic biomarkers and cancer risk adjusted for numerous potential confounders.

RESULTS:

There was an average interval of 8 years between baseline blood draw and cancer diagnosis. The baseline prevalence of APCA seropositivity was 10.0% and 14.5% in subjects who developed GCA and GNCA, respectively. APCA seropositivity was inversely associated with later development of GCA (OR 0.42, 95%CI 0.24-0.75), but not significantly associated with later development of GNCA (OR 0.82, 95%CI 0.50-1.36) or ESCC (OR 1.05, 95%CI 0.58-1.88). APCA seropositivity was significantly associated with low pepsinogen I/II ratios (OR 3.69, 95%CI 1.66-8.21) and individuals with low pepsinogen I/II ratios who were seronegative for APCA had the highest risk of both GCA and GNCA.

CONCLUSIONS:

APCA seropositivity measured years prior to diagnosis was associated with prevalent atrophic gastritis but inversely associated with incident GCA in this Chinese population.

IMPACT:

APCA may contribute to a growing list of serological markers that can improve risk stratification for gastric cancer.

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