Abstract
Helicobacter pylori (H. pylori) has been recognized as a cause of gastrointestinal diseases and progress of the pathology of gastrointestinal diseases is related to the genotype of H. pylori. Published studies have indicated that the H. pylori vacuolating cytotoxin gene A (vacA) i1/i2 genotype is associated with peptic ulcer disease (PUD) and gastric cancer (GC), but their conclusions are inconsistent. This study aimed to further assess the risk of vacA i gene for PUD and/or GC. A systematic search was conducted across three main electronic databases (PubMed, Web of Science, and CNKI). A meta‐analysis was then performed on the pooled data of the published articles to estimate the overall influence of vacA i polymorphisms on PUD and/or GC by crude odds ratio (OR) with 95% confidence intervals (CI). The reliability of the results were confirmed by publication bias and sensitivity analysis of included studies. A total of 14 studies were selected according to the specific inclusion and exclusion criteria. The pooled results revealed that patients with GC were more vulnerable to infection by H. pylori i1 genotype (OR = 5.12; 95% CI: 2.66–9.85; P < 0.001) than those with chronic gastritis or nonulcer disease. Moreover, the results of subgroup analysis indicated that the i1 genotype of H. pylori was associated with an increased GC risk (OR = 10.89; 95% CI: 4.11–20.88; P < 0.001) in the Middle Asian population. The H. pylori vacA i1 genotype is associated with an increased GC risk, especially in the Middle Asian population.
Highlights
Helicobacter pylori (H. pylori) has been recognized as a cause of gastrointestinal diseases and progress of the pathology of gastrointestinal diseases is related to the genotype of H. pylori
Published studies have indicated that the H. pylori vacuolating cytotoxin gene A i1/i2 genotype is associated with peptic ulcer disease (PUD) and gastric cancer (GC), but their conclusions are inconsistent
A metaanalysis was performed on the pooled data of the published articles to estimate the overall influence of vacuolating cytotoxin gene A (vacA) i polymorphisms on PUD and/or GC by crude odds ratio (OR) with 95% confidence intervals (CI)
Summary
Helicobacter pylori (H. pylori) has been recognized as a cause of gastrointestinal diseases and progress of the pathology of gastrointestinal diseases is related to the genotype of H. pylori. Published studies have indicated that the H. pylori vacuolating cytotoxin gene A (vacA) i1/i2 genotype is associated with peptic ulcer disease (PUD) and gastric cancer (GC), but their conclusions are inconsistent. It is estimated that half of the global population have Helicobacter pylori (H. pylori) and this bacteria is proven to be related to gastrointestinal diseases, including chronic gastritis, peptic ulcers, and gastric cancer (GC) [1]. Abbreviations babA2, blood group antigen-binding adhesion protein A2; cagA, cytotoxin-associated gene A; CG, chronic gastritis; CI, confidence interval; DU, duodenal ulcer; dupA, duodenal ulcer promoting; E, East Asia; GC, gastric cancer; GU, gastric ulcer; H. pylori, Helicobacter pylori; v2, Chi square value; M, Middle Asia; NUD, nonulcer disease; oipA, outer inflammatory protein gene; OR, odds ratio; PUD, peptic ulcer disease; U, Europe; vacA, the vacuolating cytotoxin gene A.
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