CagA+ Helicobacter pylori infection and gastric cancer risk in the EPIC-EURGAST study.
Сравнительное исследованиеСтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Palli Domenico, Masala Giovanna, Del Giudice Giuseppe, Plebani Mario, Basso Daniela, Berti Duccio, Numans Mattijs E, Ceroti Marco, Peeters Petra H M, Bueno de Mesquita H Bas, Buchner Frederike L, Clavel-Chapelon Francoise, Boutron-Ruault Marie-Christine, Krogh Vittorio, Saieva Calogero, Vineis Paolo, Panico Salvatore, Tumino Rosario, Nyrén Olof, Simán Henrik, Berglund Goran, Hallmans Goran, Sanchez Maria-Jose, Larrãnaga Nerea, Barricarte Aurelio, Navarro Carmen, Quiros Jose R, Key Tim, Allen Naomi, Bingham Sheila, Khaw Kay Tee, Boeing Heiner, Weikert Cornelia, Linseisen Jakob, Nagel Gabriele, Overvad Kim, Thomsen Reimar W, Tjonneland Anne, Olsen Anja, Trichoupoulou Antonia, Trichopoulos Dimitrios, Arvaniti Athina, Pera Guillem, Kaaks Rudolf, Jenab Mazda, Ferrari Pietro, Nesi Gabriella, Carneiro Fatima, Riboli Elio, Gonzalez Carlos A
Аннотация
Helicobacter pylori (H. pylori), atrophic gastritis, dietary and life-style factors have been associated with gastric cancer (GC). These factors have been evaluated in a large case-control study nested in the European Prospective Investigation into Cancer and Nutrition carried out in 9 countries, including the Mediterranean area. Participants, enrolled in 1992-1998, provided life-style and dietary information and a blood sample (360,000; mean follow-up: 6.1 years). For 233 GC cases diagnosed after enrolment and their 910 controls individually-matched by center, gender, age and blood donation date H. pylori antibodies (antilysate and antiCagA) and plasma Pepsinogen A (PGA) were measured by ELISA methods. Severe chronic atrophic gastritis (SCAG) was defined as PGA circulating levels <22 microg/l. Overall, in a conditional logistic regression analysis adjusted for education, smoke, weight and consumption of total vegetables, fruit, red and preserved meat, H. pylori seropositivity was associated with GC risk. Subjects showing only antibodies anti-H. pylori lysate, however, were not at increased risk, while those with antiCagA antibodies had a 3.4-fold increased risk. Overall, the odds ratio associated with SCAG was 3.3 (95% CI 2.2-5.2). According to site, the risk of noncardia GC associated with CagA seropositivity showed a further increase (OR 6.5; 95% CI 3.3-12.6); on the other hand, a ten-fold increased risk of cardia GC was associated with SCAG (OR 11.0; 95% CI 3.0-40.9). These results support the causal relationship between H. pylori CagA+ strains infection, and GC in these European populations even after taking into account dietary habits. This association was limited to distal GC, while serologically defined SCAG was strongly associated with cardia GC, thus suggesting a divergent risk pattern for these 2 sites.