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Carcinogenic Helicobacter pylori in gastric pre-cancer and cancer lesions: Association with tobacco-chewing
Arvind Pandey, Satyendra Chandra Tripathi, Sutapa Mahata, Kanchan Vishnoi, Shirish Shukla, Sri Prakash Misra, Vatsala Misra, Suresh Hedau, Ravi Mehrotra, Manisha Dwivedi, Alok C Bharti
Arvind Pandey, Sutapa Mahata, Kanchan Vishnoi, Shirish Shukla, Suresh Hedau, Ravi Mehrotra, Alok C Bharti, Division of Molecular Oncology, Institute of Cytology and Preventive Oncology (ICMR), Noida 201301, India
Arvind Pandey, Center for Biotechnology, University of Allahabad, Allahabad 211002, India
Satyendra Chandra Tripathi, Clinical Cancer Prevention-Research, UT MD Anderson Cancer Center, Houston, TX 77030, United States
Sri Prakash Misra, Manisha Dwivedi, Department of Gastroenterology, MLN Medical College, Allahabad 211002, India
Vatsala Misra, Department of Pathology, MLN Medical College, Allahabad 211002, India
Author contributions: Pandey A participated in study design, collected samples, performed major experimental work, and assisted in data analysis and manuscript preparation; Tripathi SC assisted in histology, manuscript drafting, and statistical analysis; Mahata S, Vishnoi K, Shukla S, and Hedau S assisted in experimental work related to polymerase chain reaction, Western blotting, and data analysis, as well as assisted with manuscript preparation; Misra SP participated in clinical evaluation, endoscopy, and sample collection; Misra V participated in histopathology and data analysis; Mehrotra R assisted in critical review and revision of the manuscript; Dwivedi M performed clinical evaluation, endoscopy, subject selection, sample collection, clinical data analysis, and participated in study design; Bharti AC conceived and designed the study, evaluated data, and critically reviewed, drafted, and communicated the final manuscript; all authors read and approved the final manuscript.
Supported by Extramural and Intramural Research Grants from the Department of Science and Technology, Department of Biotechnology and Indian Council of Medical Research, Government of India to Bharti AC and ICMR Senior Research Fellowship, 3/2/2/11/2010/NCD-III to Pandey A
Correspondence to: Dr. Alok C Bharti, Division of Molecular Oncology, Institute of Cytology and Preventive Oncology (ICMR), I-7, Sector-39, Noida 201301, India. bhartiac@icmr.org.in
Telephone: +91-120-2575838 Fax: +91-120-2575838
Received: September 22, 2013
Revised: December 12, 2013
Accepted: February 20, 2014
Published online: June 14, 2014
AIM: To investigate the low gastric cancer incidence rate relative to the highly prevalent Helicobacter pylori (H. pylori) infection; data relevant to H. pylori infection during gastric carcinogenesis in Indian patients is currently lacking.
METHODS: The present study examines the prevalence of H. pylori infection in DNA derived from 156 endoscopic gastric biopsies of different disease groups that represent gastric pre-cancer [intestinal metaplasia (n = 15), dysplasia (n = 15)], cancer [diffuse adenocarcinoma (n = 44), intestinal adenocarcinoma (n = 21)], and symptomatic but histopathologically-normal controls (n = 61). This was done by generic ureC polymerase chain reaction (PCR) and cagA-specific PCR that could specifically identify the carcinogenic H. pylori strain.
RESULTS: Our analysis showed the presence of H. pylori infection in 61% of symptomatic histopathologically-normal individuals, however only 34% of control tissues were harboring the cagA+ H. pylori strain. A similar proportion of H. pylori infection (52%) and cagA (26%) positivity was observed in the tumor tissue of the gastric cancer group. In comparison, H. pylori infection (90%) and cagA positivity (73%) were the highest in gastric pre-cancer lesions. In relation to tobacco and alcohol abuse, H. pylori infection showed an association with tobacco chewing, whereas we did not observe any association between tobacco smoking or alcohol abuse with prevalence of H. pylori infection in the tissue of any of the patient groups studied.
CONCLUSION: High incidence of H. pylori infection and carcinogenic cagA positive strain in pre-cancer lesions during gastric carcinogenesis may be associated with the habit of chewing tobacco.
Core tip: The manuscript deals with the role of Helicobacter pylori (H. pylori) infection and its carcinogenic cagA positivity during gastric cancer progression from normal to pre-cancer and pre-cancer to adenocarcinoma, as well as its association with tobacco and alcohol use in these patients. Results showed that H. pylori infection in general, and its carcinogenic cagA positive strains in particular, were associated with tobacco chewing.
