Meta-analysis of the relationship between cagA seropositivity and gastric cancer - PubMed (original) (raw)
Meta-Analysis
Meta-analysis of the relationship between cagA seropositivity and gastric cancer
Jia Qing Huang et al. Gastroenterology. 2003 Dec.
Abstract
Background & aims: Reports in the literature regarding the relationship of infection with cagA -positive strains of Helicobacter pylori to gastric cancer over and above H. pylori infection alone are conflicting. The aim of this study was to estimate the magnitude of the risk for gastric cancer associated with cagA seropositivity and to identify any sources of heterogeneity between studies.
Methods: A meta-analysis of case-control studies with age- and sex-matched controls, which provided raw data on the infection rates with H. pylori and cagA strains of H. pylori as detected by serology or polymerase chain reaction DNA, was performed.
Results: A comprehensive literature search identified 16 qualified studies with 2284 cases and 2770 controls. H. pylori and cagA seropositivity significantly increased the risk for gastric cancer by 2.28- and 2.87-fold, respectively. Among H. pylori -infected populations, infection with cagA -positive strains further increased the risk for gastric cancer by 1.64-fold (95% confidence interval [CI], 1.21-2.24) overall and by 2.01-fold (95% CI, 1.21-3.32) for noncardiac gastric cancer. Gastric cancer at the cardia is not associated with H. pylori infection or cagA -positive strains of H. pylori. Patient age and site of gastric cancer contributed to the heterogeneity between studies.
Conclusions: Infection with cagA -positive strains of H. pylori increases the risk for gastric cancer over the risk associated with H. pylori infection alone. Searching for cagA status over H. pylori infection may confer additional benefit in identifying populations at greater risk for gastric cancer.
Comment in
- cagA-seropositive strains of Helicobacter pylori increase the risk for gastric cancer more than the presence of H pylori alone.
Chiba N. Chiba N. Can J Gastroenterol. 2004 May;18(5):341-3. doi: 10.1155/2004/424018. Can J Gastroenterol. 2004. PMID: 15152286 No abstract available. - Meta-analysis of the relationship between CagA seropositivity and gastric cancer.
Azuma T, Ohtani M, Yamazaki Y, Higashi H, Hatakeyama M. Azuma T, et al. Gastroenterology. 2004 Jun;126(7):1926-7; author reply 1927-8. doi: 10.1053/j.gastro.2004.04.049. Gastroenterology. 2004. PMID: 15188206 No abstract available. - Helicobacter pylori and gastric cancer.
Rothenbacher D, Brenner H. Rothenbacher D, et al. Gastroenterology. 2004 Jun;126(7):1927; author reply 1927-8. doi: 10.1053/j.gastro.2004.04.047. Gastroenterology. 2004. PMID: 15188207 No abstract available.
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