Helicobacter pylori multiplex serology and risk of non-cardia and cardia gastric cancer: a case-cohort study and meta-analysis
Year: 2023
Type: article
Abstract: BACKGROUND: Helicobacter pylori infection is a major cause of non-cardia gastric cancer (NCGC), but uncertainty remains about the associations between sero-positivity to different H. pylori antigens and risk of NCGC and cardia gastric cancer (CGC) in different populations. METHODS: A case-cohort study in China included ∼500 each of incident NCGC and CGC cases and ∼2000 subcohort participants. Sero-positivity to 12 H. pylori antigens was measured in baseline plasma samples using a multiplex assay. Hazard ratios (HRs) of NCGC and CGC for each marker were estimated using Cox regression. These were further meta-analysed with studies using same assay. RESULTS: In the subcohort, sero-positivity for 12 H. pylori antigens varied from 11.4% (HpaA) to 70.8% (CagA). Overall, 10 antigens showed significant associations with risk of NCGC (adjusted HRs: 1.33 to 4.15), and four antigens with CGC (HRs: 1.50 to 2.34). After simultaneous adjustment for other antigens, positive associations remained significant for NCGC (CagA, HP1564, HP0305) and CGC (CagA, HP1564, HyuA). Compared with CagA sero-positive only individuals, those who were positive for all three antigens had an adjusted HR of 5.59 (95% CI 4.68-6.66) for NCGC and 2.17 (95% CI 1.54-3.05) for CGC. In the meta-analysis of NCGC, the pooled relative risk for CagA was 2.96 (95% CI 2.58-3.41) [Europeans: 5.32 (95% CI 4.05-6.99); Asians: 2.41 (95% CI 2.05-2.83); Pheterogeneity<0.0001]. Similar pronounced population differences were also evident for GroEL, HP1564, HcpC and HP0305. In meta-analyses of CGC, two antigens (CagA, HP1564) were significantly associated with a higher risk in Asians but not Europeans. CONCLUSIONS: Sero-positivity to several H. pylori antigens was significantly associated with an increased risk of NCGC and CGC, with varying effects between Asian and European populations.
DOI: 10.1093/ije/dyad007
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,899
Funders: World Health Organization, Wellcome Trust, Cancer Research UK, British Heart Foundation, National Natural Science Foundation of China, Kadoorie Charitable Foundation, Centers for Disease Control and Prevention, Medical Research Council, National Key Research and Development Program of China
Awards: China Kadoorie Biobank (CKB), G1144881344, G1178407541, G1222188272, G1309204960, G1347923144, China Kadoorie Biobank of 0.5 million adults, G1630586902, G1649993721, G1846601053, G1950879837, G2198095530, G2212417510, G2243627235, G229129443, China Kadoorie Biobank (CKB) prospective study of 0.5 million adults, G2602018492, G2628120876, G2635875610, G2756121469, G2769288755, G2870375487, G2910349016, G2920419711, G3000638811, G3054597888, G3165331058, G3217496469, G3420593716, G3537693707, G3646513721, G3731018732, G3760141824, The Kadoorie Biobank study., G3910655000, G3919254609, G39798324, G4051821870, G4263251407, G4332877414, G4336266969, G4490466916, G4708679710, G4873353636, G513260739, G5248341131, G5258329143, China Kadoorie Biobank (CKB) of 0.5 million adults., G5594543866, G578778246, G5789000802, G6184605720, G6195916859, G6266108309, G6269436210, G646019390, G6665326142, G668427470, G688599753, G7036255855, G7174882783, G7337440251, G7343054190, G7434196582, G7475101988, G7517169392, G7813753016, G7979847963, G798245942, G8038921994, G8043570889, G8509280843, G850960841, G952493157
OpenAlex ID: W4324017878