Published online Sep 21, 2018. doi: 10.3748/wjg.v24.i35.4061
Peer-review started: July 17, 2018
First decision: July 31, 2018
Revised: August 2, 2018
Accepted: August 24, 2018
Article in press: August 24, 2018
Published online: September 21, 2018
To clarify the role of serum anti-Helicobacter pylori (H. pylori) antibody titers in gastric cancer.
In this cross-sectional study, the effect of patients’ baseline characteristics and endoscopic findings on their serum antibody titers were assessed. We evaluated consecutive patients who underwent esophagogastroduodenoscopy and their first evaluation for H. pylori infection using a serum antibody test. We excluded patients with a history of eradication therapy. The participants were divided into four groups according to their E-plate serum antibody titer. Patients with serum antibody titers < 3, 3-9.9, 10-49.9, and ≥ 50 U/mL were classified into groups A, B, C, and D, respectively.
In total, 874 participants were analyzed with 70%, 16%, 8.7%, and 5.1% of them in the groups A, B, C, and D, respectively. Patients in group C were older than patients in groups A and B. Gastric open-type atrophy, intestinal metaplasia, enlarged folds, diffuse redness, and duodenal ulcers were associated with a high titer. Regular arrangements of collecting venules, fundic gland polyps, superficial gastritis, and gastroesophageal reflux disease were related to a low titer. Multivariate analysis revealed that nodularity (P = 0.0094), atrophy (P = 0.0076), and age 40-59 years (vs age ≥ 60 years, P = 0.0090) were correlated with a high serum antibody titer in H. pylori-infected patients. Intestinal metaplasia and atrophy were related to age ≥ 60 years in group C and D.
Serum antibody titer changes with age, reflects gastric mucosal inflammation, and is useful in predicting the risk of gastric cancer.
Core tip: A positive-low serum anti-Helicobacter pylori (H. pylori) antibody titer (E-plate Eiken) (10-49.9 U/mL) and a negative-high titer (3-9.9 U/mL) are associated with intestinal-type gastric cancer. A positive-high titer (≥ 50 U/mL) correlates with diffuse-type gastric cancer. Few studies have reported on the relationship between the serum antibody titer and endoscopic findings. In H. pylori-infected patients, a high titer of serum antibody was associated with gastric nodularity and atrophy. In H. pylori-infected patients, the antibody titer decreased in patients aged 60 years. Intestinal metaplasia and gastric atrophy were related to age ≥ 60 years in patients with positive titers.