TITLE

Relationship between Helicobacter pylon infection and gastric atrophy and the stages of the oesophageal inflammation, metaplasia, adenocarcinoma sequence: results from the FDNBAR case—control study

AUTHOR(S)
Anderson, L. A.; Murphy, S. J.; Johnston, B. T.; Watson, R. G. P.; Ferguson, H. R.; Bamford, K. B.; Ghazy, A.; McCarron, P.; McGuigan, J.; Reynolds, J. V.; Comber, H.; Murray, L. J.
PUB. DATE
June 2008
SOURCE
Gut;Jun2008, Vol. 57 Issue 6, p734
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: A number of studies have shown an inverse association between infection with Helicobacter pylori and oesophageal adenocarcinoma (OAC). The mechanism of the apparent protection against OAC by H pylori infection and, in particular, the role of gastric atrophy is disputed. The relationship between all stages of the oesophageal inflammation, metaplasia, adenocarcinoma sequence and H pylori/infection and gastric atrophy was explored. Methods: A case-control study involving 260 population controls, 227 OAC, 224 Barretts oesophagus (BO) and 230 reflux oesophagitis (RO) patients recruited within Ireland was carried out. H pylori and CagA (cytotoxin-associated gene product A) infection was diagnosed serologically by western blot, and pepsinogen I and II levels were measured by enzyme immunoassay. Gastric atrophy was defined as a pepsinogen I/II ratio of <3. Results: H pylori seropositivity was inversely associated with OAC, BO and RO; adjusted ORs (95% CIs), 0.49 (0.31 to 0.76), 0.35 (0.22 to 0.56) and 0.42 (0.27 to 0.65), respectively. Gastric atrophy was uncommon (5.3% of all subjects), but was inversely associated with non-junctional OAC, BO and RO; adjusted ORs 195% CIs), 0.34 (0.10 to 1.24), 0.23 (0.05 to 0.96) and 0.27 (0.08 to 0.88), respectively. Inverse associations between H pylori and the disease states remained in gastric atrophy- negative patients. Conclusion: H pylori/infection and gastric atrophy are associated with a reduced risk of OAC, BO and RO. While use of the pepsinogen I/II ratio as a marker for gastric atrophy has limitations, these data suggest that although gastric atrophy is involved it may not fully explain the inverse associations observed with H pylori infection.
ACCESSION #
32531195

 

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