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World J Gastroenterol. Dec 7, 2005; 11(45): 7131-7135
Published online Dec 7, 2005. doi: 10.3748/wjg.v11.i45.7131
Prevalence of Helicobacter pylori infection and intestinal metaplasia in subjects who had undergone surgery for gastric adenocarcinoma in Northwest Italy
Giorgio Palestro, Rinaldo Pellicano, Gian Ruggero Fronda, Guido Valente, Marco De Giuli, Tito Soldati, Agostino Pugliese, Stefano Taraglio, Mauro Garino, Donata Campra, Miguel Angel Cutufia, Elena Margaria, Giancarlo Spinzi, Aldo Ferrara, Giorgio Marenco, Mario Rizzetto, Antonio Ponzetto
Giorgio Palestro, Department of Oncology, University of Torino, Italy
Rinaldo Pellicano, Mario Rizzetto, Antonio Ponzetto, Department of Gastro-Hepatology, Ospedale S. Giovanni Battista (Molinette), Torino, Italy
Gian Ruggero Fronda, Mauro Garino, Donata Campra, Department of Surgery, Ospedale S. Giovanni Battista (Molinette), Torino, Italy
Guido Valente, Department of Pathology, University of Piemonte Orientale, Novara, Italy
Marco De Giuli, Department of Surgery, Ospedale S. Giovanni Antica Sede, Torino, Italy
Tito Soldati, Department of Surgery, Ospedale degli Infermi, Biella, Italy
Agostino Pugliese, Department of Infectious Diseases, University of Torino, Italy
Stefano Taraglio, Department of Pathology, Ospedale Maria Vittoria, Torino, Italy
Miguel Angel Cutufia, Department of Biology, Biochemistry and Genetics, University of Torino, Italy
Elena Margaria, Department of Pathology, Ospedale S. Giovanni Antica Sede, Torino, Italy
Giancarlo Spinzi, Gastroenterology Unit, Ospedale Valduce, Como, Italy
Aldo Ferrara, Gastroenterology Unit, Ospedale di Legnano, Legnano, Italy
Giorgio Marenco, General Medicine Unit, Ospedale Santa Corona, Pietra Ligure, Italy
Author contributions: All authors contributed equally to the work.
Supported by the grants from Regione Piemonte, Ministry of Instruction, University and Research, University of Torino, AIRC, Stola AutoSpA
Correspondence to: Professor Antonio Ponzetto, Department of Internal Medicine, University of Torino and Ambulatorio di Gastroenterologia, Ospedale S Giovanni Battista, Via Chiabrera 34, III piano, 10126 Torino, Italy. ponzetto@inwind.it
Telephone: +39-11-6336033 Fax: +39-11-6336033
Received: August 13, 2004
Revised: October 3, 2004
Accepted: October 6, 2004
Published online: December 7, 2005

AIM: To investigate the seroprevalence of Helicobacter pylori (H pylori) infection and its more virulent strains as well as the correlation with the histologic features among patients who had undergone surgery for gastric cancer (GC).

METHODS: Samples from 317 (184 males, 133 females, mean age 69±3.4 years) consecutive patients who had undergone surgery for gastric non-cardia adenocarcinoma were included in the study. Five hundred and fifty-five (294 males, 261 females, mean age 57.3±4.1 years) patients consecutively admitted to the Emergency Care Unit served as control. Histological examination of tumor, lymph nodes and other tissues obtained at the time of surgery represented the diagnostic “gold standard”. An enzyme immunosorbent assay was used to detect serum anti-H pylori (IgG) antibodies and Western blotting technique was utilized to search for anti-CagA protein (IgG).

RESULTS: Two hundred and sixty-one of three hundred and seventeen (82.3%) GC patients and 314/555 (56.5%) controls were seropositive for anti-H pylori (P<0.0001; OR, 3.58; 95%CI, 2.53-5.07). Out of the 317 cases, 267 (84.2%) were seropositive for anti-CagA antibody vs 100 out of 555 (18%) controls (P<0.0001; OR, 24.30; 95%CI, 16.5-35.9). There was no difference between the frequency of H pylori in intestinal type carcinoma (76.2%) and diffuse type cancer (78.8%). Intestinal metaplasia (IM) was more frequent but not significant in the intestinal type cancer (83.4% vs 75.2% in diffuse type and 72.5% in mixed type). Among the patients examined for IM, 39.8% had IM type I, 8.3% type II and 51.9% type III (type III vs others, P = 0.4).

CONCLUSION: This study confirms a high seroprevalence of H pylori infection in patients suffering from gastric adenocarcinoma and provides further evidence that searching for CagA status over H pylori infection might confer additional benefit in identifying populations at greater risk for this tumor.

Keywords: H pylori infection, Gastric cancer, Intestinal metaplasia, Italy