Abstract
BackgroundHelicobacter pylori (HP) and Epstein-Barr virus (EBV) have been associated with cancer development. We evaluated the prevalence of HP, HP CagA+ and EBV infection in gastric cancer (GC) samples from adults and in gastric tissues from patients who underwent upper endoscopy (UE).MethodsSamples from UE and GC were collected to investigate the presence of HP infection and the HP virulence factor CagA by a urease test and PCR. The presence of EBV was detected by Eber-1 in situ hybridization.ResultsIn UE, 85.5% of juvenile patients showed some degree of gastritis (45.3% of patients with mild gastritis and 54.7% with moderate/severe gastritis) and patients with mild gastritis were younger than patients with moderate/severe gastritis. Among adults, 48.7% presented mild gastritis and 51.3% moderate/severe gastritis. HP infection was detected in 0% of normal mucosa, 58.5% of juvenile gastritis patients, 69.2% of adult gastritis patients and 88% of GC patients. In these same groups, HP CagA+ was detected in 0%, 37.7%, 61.5% and 67.2% of tissue samples, respectively. In juvenile patients, HP infection was more common in those with gastritis than in normal samples (p = 0.004). The patients with either HP or HP CagA+ were older than patients without these pathogens (p < 0.05). In juvenile patients, HP infection was more frequent in cases of moderate/severe gastritis than in cases of mild gastritis (p = 0.026). Moreover, in patients with GC, HP infection was more frequent in males than in females (p = 0.023). GC patients with HP CagA+ were older than patients with HP CagA- (p = 0.027). HP CagA+ was more common in intestinal-type than diffuse-type GC (p = 0.012). HP CagA+ was also associated with lymph-node (p = 0.024) and distal (p = 0.005) metastasis. No association between EBV infection and HP infection or any clinicopathological variable was detected.ConclusionsOur results suggest that HP is involved in the pathophysiology of severe gastric lesions and in the development of GC, particularly when CagA+ is present. EBV was not the primary pathogenic factor in our samples.
Highlights
Helicobacter pylori (HP) and Epstein-Barr virus (EBV) have been associated with cancer development
This study aimed to assess the prevalence of HP and EBV infection, as well as the cytotoxicity associated gene A (CagA)-positive status of HP, in gastric tissues from juvenile and adult patients undergoing upper endoscopy (UE) and in tumor specimens from adult patients with gastric cancer (GC)
The proportion of males was higher in the cohort of GC patients (p < 0.001, OR = 3.365, 95% CI = 1.784 – 6.345) and adult UE patients (p = 0.014, OR = 2.827, 95% CI = 1.233 – 6.485) than among juvenile UE patients
Summary
Helicobacter pylori (HP) and Epstein-Barr virus (EBV) have been associated with cancer development. Several studies have been performed to understand the role of pathogens that infect the human stomach, Helicobacter pylori (HP) and Epstein-Barr virus (EBV), in gastric carcinogenesis [2,3,4,5]. In 1994, the International Agency for Research on Cancer (IARC) defined HP as a group 1 carcinogen [6,7]. This bacterium colonizes the gastric mucosa of more than 50% of the world’s population [8]. The HP cytotoxicity associated gene A (CagA) is one of the most significant virulence factors of this bacteria, and it has been associated with risk for GC [10]
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