Abstract

BackgroundPrevious studies have revealed the significance of Helicobacter pylori (H. pylori) infection as a risk factor of gastric cancer. Cytotoxin-associated gene A (cagA) positivity has been demonstrated to determine the clinical outcome of H. pylori infection in the presence of SHP-2 (src homology 2 domain-containing protein tyrosine phosphatase-2). This study aimed to examine the formerly reported association of G/A PTPN11 (protein-tyrosine phosphatase, nonreceptor-type 11) polymorphism (rs2301756) with gastric atrophy, as well as the association with gastric cancer in a Japanese population using a large sample size.MethodsStudy subjects were 583 histologically diagnosed patients with gastric cancer (429 males and 154 females) and age- and sex-frequency-matched 1,636 non-cancer outpatients (1,203 males and 433 females), who visited Aichi Cancer Center Hospital between 2001–2005. Serum anti-H. pylori IgG antibody and pepsinogens were measured to evaluate H. pylori infection and gastric atrophy, respectively. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by a logistic model.ResultsAmong H. pylori seropositive non-cancer outpatients, the age- and sex-adjusted OR of gastric atrophy was 0.82 (95% CI 0.62–1.10, P = 0.194) for G/A, 0.84 (95% CI 0.39–1.81, P = 0.650) for A/A, and 0.83 (95% CI 0.62–1.09, P = 0.182) for G/A+A/A, relative to G/G genotype, and that of severe gastric atrophy was 0.70 (95% CI 0.47–1.04, P = 0.079), 0.56 (95% CI 0.17–1.91, P = 0.356), and 0.68 (95% CI 0.46–1.01, P = 0.057), respectively. Among H. pylori infected subjects (H. pylori seropositive subjects and seronegative subjects with gastric atrophy), the adjusted OR of severe gastric atrophy was further reduced; 0.62 (95% CI 0.42–0.90, P = 0.012) for G/A+A/A. The distribution of the genotype in patients with gastric cancer was not significantly different from that for H. pylori infected subjects without gastric atrophy.ConclusionOur study results revealed that those with the A/A genotype of PTPN11 rs2301756 polymorphism are at lower risk of severe gastric atrophy, but are not associated with a decreased risk of gastric cancer, which partially supported our previous finding that the polymorphism in the PTPN11 gene encoding SHP-2 was associated with the gastric atrophy risk in H. pylori infected Japanese. The biological roles of this PTPN11 polymorphism require further investigation.

Highlights

  • Previous studies have revealed the significance of Helicobacter pylori (H. pylori) infection as a risk factor of gastric cancer

  • We tested the trend for H. pylori infection, gastric atrophy or gastric cancer development by sex or age categories, which revealed significant trend for higher H. pylori infection rate in males (P-value for trend < 0.001) and higher age categories (P < 0.001), and for higher prevalence of gastric atrophy in higher age categories (P < 0.001)

  • This study revealed that those who harbor A allele of the PTPN11 rs2301756 polymorphism at intron 3 had a significantly lower risk of severe gastric atrophy

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Summary

Introduction

Previous studies have revealed the significance of Helicobacter pylori (H. pylori) infection as a risk factor of gastric cancer. Helicobacter pylori (H. pylori) infection is a well-established risk factor of gastric cancer through the development of gastric atrophy and subsequent precancerous lesions. Host proinflammatory genetic factors in combination with bacterial virulence factors such as CagA have been reported to determine the severity of gastric damage and the eventual clinical outcome of H. pylori infection [3,4]. In East Asian populations, great majority of H. pylori are cagA-positive strains. The grade of gastric atrophy and gastric cancer risk is higher in patients with East Asian cagA-positive strains than in those with cagA-negative or Western cagA-positive strains [8]

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