Role of Helicobacter pylori cagA(+) strains and specific host immune responses on the development of premalignant and malignant lesions in the gastric cardia.

Peek RM, Vaezi MF, Falk GW, Goldblum JR, Perez-Perez GI, Richter JE, Blaser MJ
Int J Cancer. 1999 82 (4): 520-4

PMID: 10404065 · DOI:10.1002/(sici)1097-0215(19990812)82:4<520::aid-ijc9>3.0.co;2-7

The incidence rates of gastric cardia and esophageal adenocarcinomas are increasing, but data suggest that carriage of cagA(+) Helicobacter pylori strains may protect against development of Barrett's esophagus and esophageal adenocarcinoma. Our aims were to examine the relationship between pre-malignant and malignant lesions in the gastric cardia and serum antibodies to H. pylori antigens in patients with and without complications of Barrett's esophagus. The prevalence of carditis was 40% in controls compared with 13% in patients with complicated or uncomplicated Barrett's esophagus and cardia adenocarcinoma (p < 0.001). Cardia intestinal metaplasia (IM) and atrophy were present and concordant in 28% of controls but less frequent in patients with Barrett's alone or with dysplasia/adenocarcinoma (0% for each, p < 0.001). Carriage of cagA(+) strains was present in 34% of patients with carditis and significantly associated with increased frequency and severity of cardia inflammation, IM, and atrophy but not with adenocarcinoma. IgA and HspA seropositivity were significantly increased in H. pylori-colonized patients with carditis compared to persons with normal cardia histology (p
Copyright 1999 Wiley-Liss, Inc.

MeSH Terms (20)

Adenocarcinoma Aged Age Factors Antibodies, Bacterial Antigens, Bacterial Bacterial Proteins Barrett Esophagus Cardia Female Gastritis Heat-Shock Proteins Helicobacter pylori Humans Immunoglobulin A Immunoglobulin G Male Metaplasia Middle Aged Precancerous Conditions Stomach Neoplasms

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