© 2001 by Oxford University Press
Journal of the National Cancer Institute, Vol. 93, No. 3, 226-233,
February 7, 2001
© 2001 Oxford University Press
REPORT |
Helicobacter pylori Seropositivity and Subsite-Specific Gastric Cancer Risks in Linxian, China
Affiliations of authors: P. J. Limburg, P. R. Taylor, S. M. Dawsey (Cancer Prevention Studies Branch, Division of Clinical Sciences), S. D. Mark (Biostatistics Branch, Division of Cancer Epidemiology and Genetics), National Cancer Institute, Bethesda, MD; Y. L. Qiao, G. Q. Wang, Y. P. Wu, X. N. Zou, Z. W. Dong, Cancer Institute, Chinese Academy of Medical Sciences, Beijing, Peoples' Republic of China; G. I. Perez-Perez, M. J. Blaser, Division of Infectious Diseases, Vanderbilt University School of Medicine and the Veterans Affairs Medical Center, Nashville, TN.
Correspondence to: Paul J. Limburg, M.D., M.P.H., Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First St., S.W., Rochester, MN 55905 (e-mail: limburg.paul{at}mayo.edu).
Background: Helicobacter pylori carriage (i.e., persistent exposure to the organism without gastric epithelial cell invasion) is an established risk factor for noncardia gastric cancer. However, its association with the risk of cancer of the gastric cardia is controversial. Consequently, we designed this prospective, nested case–control study to further explore the subsite-specific gastric cancer risks associated with H. pylori seropositivity (a surrogate marker for persistent exposure). Methods: A total of 99 patients with gastric cardia cancer, 82 patients with noncardia gastric cancer, and 192 cancer-free subjects were selected from among the participants (n = 29 584) of a nutrition intervention trial previously conducted in Linxian, China. H. pylori seropositivity was determined by assaying for the presence of H. pylori whole cell and CagA antibodies in baseline serum samples from all subjects. Seropositivity was defined as one or both serum assays being positive. Odds ratios (ORs) for subsite-specific gastric cancer were estimated by multivariate logistic regression analyses. All statistical comparisons were two-sided (
= .05). Results: H. pylori seropositivity rates for subjects with gastric cardia cancer, noncardia gastric cancer, and gastric cardia and noncardia cancers combined were 70% (P = .02), 72% (P = .01), and 71% (P = .003) compared with 56% for cancer-free control subjects. OR estimates for H. pylori seropositivity were 1.87 (95% confidence interval [CI] = 1.10 to 3.17) for gastric cardia cancer, 2.29 (95% CI = 1.26 to 4.14) for noncardia gastric cancer, and 2.04 (95% CI = 1.31 to 3.18) for gastric cardia and noncardia cancers combined. Conclusions: H. pylori seropositivity was associated with increased risks for both gastric cardia cancer and noncardia gastric cancer in this well-characterized cohort. Thus, H. pylori carriage may increase the risk of cancer throughout the stomach.
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