Abstract
BackgroundData on implications of a high positive titer of serum anti-Helicobacter pylori antibody on gastric cancer (GC) is limited. This study aimed to investigate the characteristics of GC with a high serum anti-H. pylori IgG (Hp-IgG) titer, and its association with diffuse-type GC.MethodsWe analyzed clinical and histological characteristics of 917 non-cardia GC patients who underwent gastrectomy. H. pylori infection was determined serologically by measuring Hp-IgG titer with immunoassay. Seropositive patients were divided into three groups (low-positive, mid-positive, and high-positive) according to the Hp-IgG titer value. Tumors were classified according to the Lauren criteria as diffuse or intestinal types.ResultsThe median age of the patients was 59.0 years, and 33.8% were female. The patents were grouped as follows: seronegative, 188 (20.5%); low-positive, 288 (31.4%); mid-positive, 290 (31.6%); and high-positive 151 (16.5%). The high-positive group was significantly younger (median age, 55.0 years), with a higher proportion of female (45.0%) and non-smokers (58.9%). The proportion of diffuse-type GC increased in the order low-, mid-, and high-positive groups (p<0.001). In univariate analysis, the factors associated with diffuse-type GC were younger age, female sex, non-smokers, and a high-positive Hp-IgG titer. Younger age, female sex, and non-smokers remained significant on multivariate analysis whereas the high-positive Hp-IgG titer showed only a tendency toward the association (p = 0.078).ConclusionsNon-cardia GC patients with a high Hp-IgG titer have distinct clinicopathologic characteristics. A high-positive Hp-IgG titer should be interpreted together with patients’ age, sex, and smoking status.
Highlights
Non-cardia gastric cancer (GC) develops with a sequence of events that evolves from atrophic gastritis and intestinal metaplasia to dysplasia and carcinoma [1]
This study aimed to investigate the characteristics of GC with a high serum anti-H. pylori IgG (Hp-IgG) titer, and its association with diffuse-type GC
Serum anti-H. pylori IgG antibody (Hp-IgG) test is widely used to determine the presence of H. pylori infection [3,4] and plays a useful role in risk assessments for the development of GC, in combination with serum pepsinogen [5,6,7]
Summary
Non-cardia gastric cancer (GC) develops with a sequence of events that evolves from atrophic gastritis and intestinal metaplasia to dysplasia and carcinoma [1]. Chronological change in Hp-IgG titers which decrease with the progression of gastric mucosal atrophy may be attributable to the association between past infection or low Hp-IgG titer and intestinal-type GC [8]. A high Hp-IgG titer may reflect mucosal inflammation resulting from active H. pylori infection and may be related to the development of diffuse-type GC [7,10,11]. The association between Hp-IgG titer and the histological type of GC remains unclear because comprehensive analyses including age, sex, and other related factors are limited. Data on implications of a high positive titer of serum anti-Helicobacter pylori antibody on gastric cancer (GC) is limited. This study aimed to investigate the characteristics of GC with a high serum anti-H. pylori IgG (Hp-IgG) titer, and its association with diffuse-type GC
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