Kokkola A, Louhimo J, Puolakkainen P, Alfthan H, Haglund C, Rautelin H. Helicobacter pylori infection and low serum pepsinogen I level as risk factors for gastric carcinoma. World J Gastroenterol 2005; 11(7): 1032-1036 [PMID: 15742409 DOI: 10.3748/wjg.v11.i7.1032]
Corresponding Author of This Article
Arto Kokkola, M.D., Department of Surgery, Meilahti Hospital, PO Box 340 (Haartmaninkatu 4), FIN-00029 HUS, Finland. arto.kokkola@hus.fi
Article-Type of This Article
Brief Reports
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World J Gastroenterol. Feb 21, 2005; 11(7): 1032-1036 Published online Feb 21, 2005. doi: 10.3748/wjg.v11.i7.1032
Table 1 Final diagnoses of 108 control patients.
Diagnosis
Number of patients
H pylori-positive (H pylori+ and/or CagA+) patients (%)
Non-ulcer gastrointestinal bleeding
26
15 (58)
Esophagitis
23
12 (52)
Dyspepsia
21
11 (52)
Gastric ulcer
14
12 (86)
Barrett's esophagus
7
2 (29)
Duodenal ulcer
4
3 (75)
Benign gastrointestinal tumor
4
2 (50)
Others
9
5 (56)
All
108
62 (57)
Table 2 Number (%) of H pylori (H pylori+), CagA (CagA+) and H pylori+ and/or CagA+ persons in 143 gastric cancer patients and 108 controls.
Cancer patients n (%)
Controls n (%)
P(χ2-test)
H pylori+
101 (70.6)
42 (38.9)
<0.001
CagA+
120 (83.9)
55 (50.9)
<0.001
H pylori+ and/or CagA +
127 (88.8)
62 (57.4)
<0.001
Table 3 Characteristics of 11 non-cardia cancer patients who did not show any evidence of previous H pylori infection (H pylori- and CagA-).
Case
Age (yr)
Sex
SPGI
PCA
Histological type of cancer
Tumor stage
1
54
Male
Normal
Normal
Intestinal
4
2
65
Male
Normal
Normal
Intestinal
4
3
76
Male
Normal
Normal
Intestinal
4
4
62
Female
Normal
Normal
Diffuse
1
5
75
Female
Low
Normal
Diffuse
2
6
44
Female
Normal
Normal
Diffuse
3
7
32
Female
Normal
Elevated
Diffuse
4
8
54
Male
Normal
Normal
Diffuse
4
9
69
Female
Normal
Normal
Diffuse
4
10
77
Male
Low
Elevated
Diffuse
4
11
78
Female
Normal
Normal
Diffuse
4
Table 4 Effect of tumor stage on the prevalence of H pylori (H pylori+) and CagA (CagA+) antibodies in 126 non-cardia gastric cancer patients.
Stage 1 (%) (n=31)
Stage 2 (%) (n=10)
Stage 3 (%) (n=30)
Stage 4 (%) (n=55)
H pylori+
80.6
70
73.3
67.3
CagA+
90.3
80
93
81.8
H pylori+ and/or CagA +
96.8
90
96.7
85.5
Table 5 Odds ratios (with 95% confidence intervals) of risk factors for the development of gastric cancer.
All gastric cancers
Non-cardia cancers only
Patients aged <55 yr1
Patients aged >55 yr2
Low SPGI
12.0 (4.1-35.3)
12.5 (4.2-37.4)
NS
16.4 (2.1-128.8)
PCA+
NS
NS
NS
NS
H pylori+ and/or CagA+
5.0 (2.5-10.0)
6.8 (3.1-14.8)
16.7(3.1-88.7)
3.1 (1.2-8.0)
Table 6 Odds ratios (with 95% confidence intervals) of risk factors for intestinal and diffuse types of gastric cancer.
Intestinal type (n = 61)
Diffuse type (n = 81)
Low SPGI
27.7 (8.5-89.5)
8.2 (2.5-27.0)
PCA+
NS
NS
H pylori+ and/or CagA+
4.1 (1.5-10.7)
6.0 (2.6-13.9)
Citation: Kokkola A, Louhimo J, Puolakkainen P, Alfthan H, Haglund C, Rautelin H. Helicobacter pylori infection and low serum pepsinogen I level as risk factors for gastric carcinoma. World J Gastroenterol 2005; 11(7): 1032-1036