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Tumor Biology

, Volume 35, Issue 12, pp 12217–12224 | Cite as

Serum Helicobacter pylori CagA antibody may not be used as a tumor marker for diagnosing gastric cancer in east Asian countries

  • Zhicheng Zhao
  • Yuhong Li
  • Shengxin Liu
  • Weihua Fu
Research Article

Abstract

Gastric cancer (GC) is a highly malignant cancer with increasing incidence and mortality worldwide. Serum Helicobacter pylori CagA antibody has been widely reported to play an important role in diagnosing GC. However, published data on this subject are inconclusive. Therefore, we performed a meta-analysis to evaluate the sensitivity and specificity of serum H. pylori CagA antibody in the diagnosis of GC. We conducted a comprehensive search to identify eligible related studies, in which the pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curves could be determined. A total of 12 studies including 1,524 cases and 3,324 controls who fulfilled all of the inclusion criteria were included for analysis. The summary estimates for serum H. pylori CagA antibody in the diagnosis of GC in these studies were pooled sensitivity 0.71 (95 % CI 0.69–0.73), specificity 0.40 (95 % CI 0.39–0.42), DOR 2.11 (95 % CI 1.55–2.8), and the area under the curve was 0.636. Our meta-analysis showed that serum H. pylori CagA antibody should not be used for detecting GC.

Keywords

Gastric cancer Anti-CagA antibody East Asia Diagnosis Meta-analysis 

References

  1. 1.
    Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol. 2006;24(14):2137–50.PubMedCrossRefGoogle Scholar
  2. 2.
    Crew KD, Neugut AI. Epidemiology of gastric cancer. World J Gastroenterol. 2006;12(3):354–62.PubMedCentralPubMedGoogle Scholar
  3. 3.
    National Comprehensive Cancer Network (2010) Clinical practice guidelines in oncology: gastric cancer. http://www.nccn.org/professionals/physician_gls/PDF/gastric.pdf. Accessed 14 August 2010.
  4. 4.
    Jeung HC, Rha SY, Noh SH, et al. Adjuvant 5-fluorouracil plus doxorubicin in D2–3 resected gastric carcinoma: 15-year experience at a single institute. Cancer. 2001;91(11):2016–25.PubMedCrossRefGoogle Scholar
  5. 5.
    Yang L, Parkin DM, Ferlay J, et al. Estimates of cancer incidence in China for 2000 and projections for 2005. Cancer Epidemiol Biomarkers Prev. 2005;14(1):243–50.PubMedGoogle Scholar
  6. 6.
    Society AAC. Global cancer facts & figures 2nd edition. American Cancer: Society; 2011.Google Scholar
  7. 7.
    Meng F, Henson R, Lang M, Wehbe H, Maheshwari S, et al. Involvement of human micro-RNA in growth and response to chemotherapy in human cholangiocarcinoma cell lines. Gastroenterology. 2006;130:2113–29.PubMedCrossRefGoogle Scholar
  8. 8.
    Garcia M, Jemal A. Global cancer facts and figures 2011. Atlanta, GA: American Cancer Society; 2011.Google Scholar
  9. 9.
    Tan YK, Fielding JW. Early diagnosis of early gastric cancer. Eur J Gastroenterol Hepatol. 2006;18:821–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Blaser M, Perez-Perez G, Kleanthous H, et al. Infection with Helicobacter pylori strains possessing CagA is associated with an increased risk of developing adenocarcinoma of the stomach. Cancer Res. 1995;55(10):2111–5.PubMedGoogle Scholar
  11. 11.
    Kuipers E, Pérez-Pérez G, Meuwissen S, Blaser M. Helicobacter pylori and atrophic gastritis: importance of the CagA status. J Natl Cancer Inst. 1995;87(23):1777–80.PubMedCrossRefGoogle Scholar
  12. 12.
    Nomura A, Lee J, Stemmermann G, Nomura R, Perez-Perez G, Blaser M. Helicobacter pylori CagA seropositivity and gastric carcinoma risk in a Japanese American population. J Infect Dis. 2002;186(8):1138–44.PubMedCrossRefGoogle Scholar
  13. 13.
    Parsonnet J, Friedman G, Orentreich N, Vogelman H. Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut. 1997;40(3):297–301.PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Argent R, Hale J, El-Omar E, Atherton J. Differences in Helicobacter pylori CagA tyrosine phosphorylation motif patterns between western and east Asian strains, and influences on interleukin-8 secretion. J Med Microbiol. 2008;57(9):1062–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Huang J, Zheng G, Sumanac K, Irvine E, Hunt R. Meta-analysis of the relationship between CagA seropositivity and gastric cancer. Gastroenterology. 2003;125(6):1636–44.PubMedCrossRefGoogle Scholar
  16. 16.
    Shiota S, Matsunari O, Watada M, Yamaoka Y. Serum Helicobacter pylori CagA antibody as a biomarker for gastric cancer in east-Asian countries. Future Microbiol. 2010;5(12):1885–93.PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009;62:e1–34.PubMedCrossRefGoogle Scholar
  18. 18.
    Whiting PF, Weswood ME, Rutjes AW, Reitsma JB, Bossuyt PN, Kleijnen J. Evaluation of QUADAS, a tool for the quality assessment of diagnostic accuracy studies. BMC Med Res Methodol. 2006;6:9.PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Mitchell H, Hazell S, Li Y, Hu P. Serological response to specific Helicobacter pylori antigens: antibody against CagA antigen is not predictive of gastric cancer in a developing country. Am J Gastroenterol. 1996;91(9):1785–8.PubMedGoogle Scholar
  20. 20.
    Shimoyama T, Fukuda S, Tanaka M, Mikami T, Munakata A, Crabtree J. CagA seropositivity associated with development of gastric cancer in a Japanese population. J Clin Pathol. 1998;51(3):225–8.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Kikuchi S, Crabtree J, Forman D, Kurosawa M. Association between infections with CagA-positive or -negative strains of Helicobacter pylori and risk for gastric cancer in young adults. Research group on prevention of gastric carcinoma among young adults. Am J Gastroenterol. 1999;94(12):3455–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Maeda S, Yoshida H, Ogura K, et al. Assessment of gastric carcinoma risk associated with Helicobacter pylori may vary depending on the antigen used: CagA specific enzyme-linked immunoadsorbent assay (ELISA) versus commercially available H. pylori ELISAs. Cancer. 2000;88(7):1530–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Ying W, Zhiquan Z, Hongjie Z, Xiaoyong Z, Lin L. CagA-positive H. pylori serology infection and its clinical significance. Jiangsu Med J. 2000;26(7):541–2. in Chinese.Google Scholar
  24. 24.
    Jianyi W, Daozeng G, Guangrong R. Relationship serology and CagA-positive H. pylori infection and gastrointestinal diseases. ACTA ACADEMIAE MEDICINAE SUZHOU. 2000;20(11):1056–8. in Chinese.Google Scholar
  25. 25.
    Limburg P, Qiao Y, Mark S, et al. Helicobacter pylori seropositivity and subsite-specific gastric cancer risks in Linxian. China J Natl Cancer Inst. 2001;93(3):226–33.CrossRefGoogle Scholar
  26. 26.
    Sasazuki S, Inoue M, Iwasaki M, et al. Effect of Helicobacter pylori infection combined with CagA and pepsinogen status on gastric cancer development among Japanese men and women: a nested case–control study. Cancer Epidemiol Biomarkers Prev. 2006;15(7):1341–7.PubMedCrossRefGoogle Scholar
  27. 27.
    Gwack J, Shin A, Kim C, et al. CagA-producing Helicobacter pylori and increased risk of gastric cancer: a nested case–control study in Korea. Br J Cancer. 2006;95(5):639–41.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Xiao-hui CHEN, Xiu-xia LEI, Bang-lao XU. Correlation between CagA Antibody against Helicobacter pylori and the gastroduodenal diseases. J Trop Med Parasitol. 2006;6(2):167–9 (in Chinese).Google Scholar
  29. 29.
    Jin-de HE, Yu-lan LIU, Huai-tang WANG, Hui YE, Jiao ZHANG. Relationship between CagA seropositivity of Helicobacter pylori and gastrointestinal malignant tumor. Journal of Chinese Physician. 2006;8(5):617–9 (in Chinese).Google Scholar
  30. 30.
    Suzuki G, Cullings H, Fujiwara S, et al. Low-positive antibody titer against Helicobacter pylori cytotoxin-associated gene A (CagA) may predict future gastric cancer better than simple seropositivity against H. pylori CagA or against H. pylori. Cancer Epidemiol Biomarkers Prev. 2007;16(6):1224–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Glas AS, Lijmer JG, Prins MH, Bonsel GJ, Bossuyt PM. The diagnostic odds ratio: a single indicator of test performance. J Clin Epidemiol. 2003;56(11):1129–35.PubMedCrossRefGoogle Scholar
  32. 32.
    Jones CM, Athanasiou T. Summary receiver operating characteristic curve analysis techniques in the evaluation of diagnostic tests. Ann Thorac Surg. 2005;79:16–20.PubMedCrossRefGoogle Scholar
  33. 33.
    Walter SD. Properties of the summary receiver operating characteristic (SROC) curve for diagnostic test data. Stat Med. 2002;21:1237–56.PubMedCrossRefGoogle Scholar

Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  1. 1.Department of General SurgeryTianjin Medical University General HospitalTianjinChina
  2. 2.Department of PathologyThe People’s Hospital of Liao ChengLiao ChengChina
  3. 3.Department of General SurgeryZhongshan Hospital of Hubei ProvinceWuhanChina

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