Article Text

other Versions

PDF
Relationship between Helicobacter pylori infection and gastric atrophy and the stages of the oesophageal inflammation, metaplasia, adenocarcinoma sequence: results from the FINBAR case-control study
  1. Lesley A Anderson (l.anderson{at}qub.ac.uk)
  1. Queen's University Belfast, United Kingdom
    1. Seamus J Murphy (s.murphy{at}qub.ac.uk)
    1. Queen's University Belfast, United Kingdom
      1. Brian T Johnston (brian.johnston{at}royalhospitals.n-i.nhs.uk)
      1. Royal Victoria Hospital, United Kingdom
        1. Peter Watson (p.watson{at}qub.ac.uk)
        1. ROYAL VICTORIA HOSPITAL, United Kingdom
          1. Heather Ferguson (hrferguson{at}doctors.org.uk)
          1. QUB, United Kingdom
            1. Kathleen B Bamford (k.bamford{at}imperial.ac.uk)
            1. Imperial College, United Kingdom
              1. A Ghazy (a.ghazy{at}imperial.ac.uk)
              1. Imperial College, United Kingdom
                1. Peter McCarron (p.mccarron{at}qub.ac.uk)
                1. QUB, United Kingdom
                  1. Jim Mc Guigan (jim.mcguigan{at}royalhospitals.n-i.nhs.uk)
                  1. Royal Hospitals, United Kingdom
                    1. John V Reynolds (reynoljv{at}tcd.ie)
                    1. St James's Hospital, Dublin 8, Eire
                      1. H. Comber (h.comber{at}ncri.ie)
                      1. National Cancer Registry Ireland, Eire
                        1. Liam J Murray (l.murray{at}qub.ac.uk)
                        1. THE QUEEN'S UNIVERSITY OF BELFAST, United Kingdom

                          Abstract

                          Objective: A number of studies have shown an inverse association between infection with Helicobacter pylori (H. 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. We explored the relationship between all stages of the oesophageal inflammation, metaplasia, adenocarcinoma sequence and H. pylori infection and gastric atrophy. Design and patients: Case-control study involving 260 population controls, 227 OAC, 224 Barrett¡¯s oesophagus (BO) and 230 reflux oesophagitis (RO) patients recruited within Ireland. H. pylori and CagA 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 odds ratios (95% CIs), 0.49 (0.31-0.76), 0.35 (0.22-0.56), and 0.42 (0.27-0.65), respectively. Gastric atrophy was uncommon (5.3% of all subjects), but was inversely associated with non-junctional OAC, BO and RO; adjusted odds ratios (95% CIs), 0.34 (0.10-1.24), 0.23 (0.05-0.96) and 0.27 (0.08-0.88), 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.

                          • Barrett's oesophagus
                          • Helicobacter pylori
                          • oesophageal adenocarcinoma
                          • pepsinogen
                          • reflux oesophagitis

                          Statistics from Altmetric.com

                          Request permissions

                          If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

                          Linked Articles