Helicobacter pylori infection and markers of gastric cancer risk in Alaska Native persons: a retrospective case-control study.

Abstract

BACKGROUND:

Alaska Native persons experience gastric cancer incidence and mortality rates that are three to four times higher than in the general United States population.

OBJECTIVE:

To evaluate pepsinogen I, pepsinogen I/II ratio, anti-Helicobacter pylori and cytotoxin-associated gene A (CagA) antibody levels, and blood group for their associations with gastric cancer development in Alaska Native people.

METHODS:

The present analysis was a retrospective case-control study that matched gastric cancers reported to the Alaska Native Tumor Registry from 1969 to 2008 to three controls on known demographic risk factors for H pylori infection, using sera from the Alaska Area Specimen Bank. Conditional logistic regression evaluated associations between serum markers and gastric cancer.

RESULTS:

A total of 122 gastric cancer cases were included, with sera predating cancer diagnosis (mean = 13 years) and 346 matched controls. One hundred twelve cases (91.8%) and 285 controls (82.4%) had evidence of previous or ongoing H pylori infection as measured by anti-H pylori antibody levels. Gastric cancer cases had a 2.63-fold increased odds of having positive anti-H pylori antibodies compared with their matched controls (P=0.01). In a multivariate model, noncardia gastric cancer (n=94) was associated with anti-H pylori antibodies (adjusted OR 3.92; P=0.004) and low pepsinogen I level (adjusted OR 6.04; P=0.04). No association between gastric cancer and blood group, anti-CagA antibodies or pepsinogen I/II ratio was found.

CONCLUSION:

Alaska Native people with gastric cancer had increased odds of previous H pylori infection. Low pepsinogen I level may function as a precancer marker for noncardia cancer.

• Authors: James William Keck, Karen M Miernyk, Lisa R Bulkow, Janet J Kelly, Brian J McMahon, Frank Sacco, Thomas W Hennessy, Michael G Bruce
• Journal: Canadian journal of gastroenterology & hepatology (Can J Gastroenterol Hepatol) Vol. 28 Issue 6 Pg. 305-10 (Jun 2014) ISSN: 2291-2797 [Electronic] Egypt
• PMID: 24945184 (Publication Type: Journal Article)

Chemical References

• Antigens, Bacterial
• Bacterial Proteins
• Biomarkers, Tumor
• Blood Group Antigens
• cagA protein, Helicobacter pylori
• Pepsinogen A

Topics

• Adult
• Alaska (epidemiology)
• Antigens, Bacterial (blood, immunology)
• Bacterial Proteins (blood, immunology)
• Biomarkers, Tumor (blood)
• Blood Group Antigens
• Female
• Helicobacter Infections (blood, complications)
• Helicobacter pylori (immunology)
• Humans
• Male
• Middle Aged
• Pepsinogen A (blood)
• Population Groups (statistics & numerical data)
• Prevalence
• Registries
• Retrospective Studies
• Risk Factors
• Stomach Neoplasms (blood, epidemiology, etiology, microbiology, prevention & control)