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Helicobacter pylori CagA status associated with gastric cancer incidence rate variability in Costa Rican regions

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Abstract

Background

We evaluated several risk factors for gastric cancer in Costa Rican regions having contrasting gastric cancer incidence rates, despite the small dimensions of the country.

Methods

A total of 180 dyspeptic patients were classified into two groups according to the gastric cancer incidence (GCI) rate in their Costa Rican region: group A, with a high GCI rate (n = 91) and group B, with a low GCI rate (n = 89). Helicobacter pylori infection was detected by rapid urease test, Gram staining, and histological observation. Antral and corpus specimens were obtained to assess the grade of inflammation, topography of gastritis, gastric atrophy, and intestinal metaplasia by histological examination. Serum CagA antibody was measured by an antigen-specific enzyme-linked immunosorbent assay.

Results

There was no significant difference in H. pylori prevalence between groups A (73%) and B (63%); however, serum CagA antibody was more frequently detected in group A (79%) than in group B (54%) [P = 0.02; odds ratio (OR), 2.68]. Among patients under 60 years of age, serum CagA antibody was even more frequently detected in group A (81%) than in group B (49%) (P < 0.01; OR, 4.50). The prevalence of corpus-predominant gastritis, atrophic gastritis, and moderate/severe grades of neutrophilic infiltration was higher in serum CagA antibody-positive patients than in CagA antibody-negative patients (P = 0.003, 0.04, and 0.002, respectively).

Conclusions

Infection with H. pylori possessing the cagA gene is associated with the development of severe gastric damage such as gastric atrophy, leading to gastric cancer, and probably influences the differences in GCI between Costa Rican regions.

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Authors and Affiliations

  1. Department of Tumor Surgery, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, 783-8505, Japan

    Sergio A Con, Michiya Kobayashi & Keijiro Araki

  2. Department of Clinical Laboratory Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan

    Hiroaki Takeuchi, Mitsuaki Nishioka, Norihito Morimoto & Tetsuro Sugiura

  3. Centro Digestivo Doctores Con-Mediplaza, San José, Costa Rica

    Sergio A Con, Ana L Valerín, Reinaldo Con-Wong, Vicky G. Con-Chin, Gil R Con-Chin & Sachiko N Yagi-Chaves

  4. Laboratorio de Patología-Mediplaza, San José, Costa Rica

    Fernando Mena U. & Fernando Brenes Pino

  5. Laboratorio Clínico Echandi-Mediplaza, San José, Costa Rica

    Guillermo Echandi & Mario Monge-Izaguirre

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  1. Sergio A Con
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  2. Ana L Valerín
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Con, S., Valerín, A., Takeuchi, H. et al. Helicobacter pylori CagA status associated with gastric cancer incidence rate variability in Costa Rican regions. J Gastroenterol 41, 632–637 (2006). https://doi.org/10.1007/s00535-006-1812-3

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  • DOI: https://doi.org/10.1007/s00535-006-1812-3

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