Meta-Analysis
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World J Gastroenterol. Jul 14, 2013; 19(26): 4242-4251
Published online Jul 14, 2013. doi: 10.3748/wjg.v19.i26.4242
Association of Helicobacter pylori babA2 with peptic ulcer disease and gastric cancer
Mo-Ye Chen, Cai-Yun He, Xue Meng, Yuan Yuan
Mo-Ye Chen, Cai-Yun He, Xue Meng, Yuan Yuan, Tumor Etiology and Screening Department of Cancer Institute and General Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Mo-Ye Chen, Cai-Yun He, Xue Meng, Yuan Yuan, Key Laboratory of Cancer Etiology and Prevention (China Medical University), Liaoning Provincial Education Department, Shenyang 110001, Liaoning Province, China
Author contributions: Chen MY and He CY contributed equally to this work; Chen MY and He CY designed the study and performed the data analysis as joint first authors; Chen MY, He CY and Meng X contributed to the discussion and drafted the manuscript; Yuan Y designed the study, contributed to the discussion and edited the manuscript as corresponding author; all authors critically reviewed the manuscript and gave final approval of the version to be published.
Supported by Grants from National Basic Research Program of China, 973 Program Ref No. 2010CB529304; the Grants of the Science and Technology Project of Liaoning province, Ref No. 2011225002; and the Grants of the Science Project of Liaoning Province, Ref [2008]621
Correspondence to: Yuan Yuan, Professor, Tumor Etiology and Screening Department of Cancer Institute and General Surgery, the First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Heping District, Shenyang 110001, Liaoning Province, China. yyuan@mail.cmu.edu.cn
Telephone: +86-24-83282153 Fax: +86-24-83282292
Received: January 18, 2013
Revised: April 3, 2013
Accepted: May 16, 2013
Published online: July 14, 2013
Abstract

AIM: To investigate the association between babA2 gene and peptic ulcer disease (PUD) and gastric cancer (GC) in Helicobacter pylori-infected populations.

METHODS: We evaluated the relationship between babA2 and clinical outcomes (PUD and GC) using a meta-analysis. A literature search was performed using the PubMed and Web of Science databases for relevant case-control studies that met the defined inclusion criteria. The ORs and 95%CIs were calculated to estimate the association between babA2 genotype and clinical outcomes. A fixed-effect or random-effect model was performed depending on the absence or presence of significant heterogeneity.

RESULTS: A total of 25 articles with 38 studies met the inclusion criteria and were finally included in this meta-analysis. The results showed that the babA2 genotype was significantly associated with an increased risk of PUD (OR = 2.069, 95%CI: 1.530-2.794, P < 0.001) and especially in the subgroup of duodenal ulcer (OR = 1.588, 95%CI: 1.141-2.209, P = 0.006). Moreover, a significant association between babA2 gene and PUD and duodenal ulcer (OR = 2.739, 95%CI: 1.860-4.032, P < 0.001; OR = 2.239, 95%CI: 1.468-3.415, P < 0.001, respectively) was observed in western countries but not in Asian countries.

CONCLUSION: We demonstrated that the presence of babA2 may be associated with increased risks for PUD, especially duodenal ulcer, in western countries.

Keywords: Helicobacter pylori, babA2, Peptic ulcer, Gastric cancer, Risk

Core tip: BabA encoded by babA2 gene is an outer member protein of Helicobacter pylori (H. pylori), which plays a key role in facilitating bacterial colonization in the stomach. The association between babA2 and H. pylori-related gastroduodenal diseases is still controversial. We summarized a total of 25 case-control articles with 38 studies in this meta-analysis and evaluated the relationship between babA2 and clinical outcomes. The presence of babA2 may contribute to increased risk of peptic ulcer disease (PUD), especially duodenal ulcer, in western countries. In Asians, babA2 genotype only showed a marginal association with PUD risk, which requires further investigation.