Patients younger than 40 years with gastric carcinoma: Helicobacter pylori genotype and associated gastritis phenotype

Massimo Rugge, Graziella Busatto, Mauro Cassaro, Yih Horng Shiao, Valentina Russo, Gioacchino Leandro, Claudio Avellini, Alfredo Fabiano, Angelo Sidoni, Antonello Covacci

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

BACKGROUND. In the general population, Helicobacter pylori (H. pylori), particularly the cagA positive strain, has been associated with intestinal- type gastric carcinoma. Gastric carcinomas are rarely observed in patients age ≤40 years. Host-related factors have been thought to be more important than environmental agents in these early-onset cancers. The aim of this study was to ascertain the possible role of H. pylori infection and that of cagA positive strains in the development of gastric carcinoma in these young patients. METHODS. In this case-control study, 105 gastric carcinoma patients (male-to-female ratio = 1.1; mean age, 34.4 years; range, 16-40 years) and an equal number of controls (matched for gender and age) were retrospectively selected from the same geographic area. The phenotypes of gastritis and H. pylori were histologically assessed, and the presence of the ureC gene, which is indicative of H. pylori infection, and the cagA genotype were determined by polymerase chain reaction. Gastric carcinoma risk was calculated by both univariate and multivariate statistical methods, taking into account the cancer phenotype, the gastritis phenotype detected in both patients and controls, and the H. pylori genotype. RESULTS. For 74 diffuse and 31 intestinal gastric carcinomas, multivariate logistic regression analysis produced results consistent with those of univariate statistical tests, showing a significant association between gastric carcinoma and both H. pylori infection (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.52-5.11) and cagA positive status (OR = 2.94; 95% CI = 1.56-5.52). CONCLUSIONS. In young Italian patients with gastric carcinoma, the significant association with cagA positive H. pylori infection suggests that the bacterium has an etiologic role in both diffuse-type and intestinal-type gastric carcinoma.

Original languageEnglish
Pages (from-to)2506-2511
Number of pages6
JournalCancer
Volume85
Issue number12
DOIs
Publication statusPublished - Jun 15 1999

Fingerprint

Gastritis
Helicobacter pylori
Stomach
Genotype
Carcinoma
Phenotype
Helicobacter Infections
Odds Ratio
Confidence Intervals
Case-Control Studies
Neoplasms
Logistic Models
Regression Analysis
Bacteria
Polymerase Chain Reaction

Keywords

  • cagA gene
  • cagA pathogenicity island
  • Cancer in youth
  • Diffuse-type gastric carcinoma
  • Environmental gastric carcinoma
  • Gastric carcinoma
  • Helicobacter pylori
  • Intestinal-type gastric carcinoma
  • Multifocal atrophic gastritis

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Patients younger than 40 years with gastric carcinoma : Helicobacter pylori genotype and associated gastritis phenotype. / Rugge, Massimo; Busatto, Graziella; Cassaro, Mauro; Shiao, Yih Horng; Russo, Valentina; Leandro, Gioacchino; Avellini, Claudio; Fabiano, Alfredo; Sidoni, Angelo; Covacci, Antonello.

In: Cancer, Vol. 85, No. 12, 15.06.1999, p. 2506-2511.

Research output: Contribution to journalArticle

Rugge, M, Busatto, G, Cassaro, M, Shiao, YH, Russo, V, Leandro, G, Avellini, C, Fabiano, A, Sidoni, A & Covacci, A 1999, 'Patients younger than 40 years with gastric carcinoma: Helicobacter pylori genotype and associated gastritis phenotype', Cancer, vol. 85, no. 12, pp. 2506-2511. https://doi.org/10.1002/(SICI)1097-0142(19990615)85:12<2506::AID-CNCR3>3.0.CO;2-I
Rugge, Massimo ; Busatto, Graziella ; Cassaro, Mauro ; Shiao, Yih Horng ; Russo, Valentina ; Leandro, Gioacchino ; Avellini, Claudio ; Fabiano, Alfredo ; Sidoni, Angelo ; Covacci, Antonello. / Patients younger than 40 years with gastric carcinoma : Helicobacter pylori genotype and associated gastritis phenotype. In: Cancer. 1999 ; Vol. 85, No. 12. pp. 2506-2511.
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abstract = "BACKGROUND. In the general population, Helicobacter pylori (H. pylori), particularly the cagA positive strain, has been associated with intestinal- type gastric carcinoma. Gastric carcinomas are rarely observed in patients age ≤40 years. Host-related factors have been thought to be more important than environmental agents in these early-onset cancers. The aim of this study was to ascertain the possible role of H. pylori infection and that of cagA positive strains in the development of gastric carcinoma in these young patients. METHODS. In this case-control study, 105 gastric carcinoma patients (male-to-female ratio = 1.1; mean age, 34.4 years; range, 16-40 years) and an equal number of controls (matched for gender and age) were retrospectively selected from the same geographic area. The phenotypes of gastritis and H. pylori were histologically assessed, and the presence of the ureC gene, which is indicative of H. pylori infection, and the cagA genotype were determined by polymerase chain reaction. Gastric carcinoma risk was calculated by both univariate and multivariate statistical methods, taking into account the cancer phenotype, the gastritis phenotype detected in both patients and controls, and the H. pylori genotype. RESULTS. For 74 diffuse and 31 intestinal gastric carcinomas, multivariate logistic regression analysis produced results consistent with those of univariate statistical tests, showing a significant association between gastric carcinoma and both H. pylori infection (odds ratio [OR] = 2.79; 95{\%} confidence interval [CI] = 1.52-5.11) and cagA positive status (OR = 2.94; 95{\%} CI = 1.56-5.52). CONCLUSIONS. In young Italian patients with gastric carcinoma, the significant association with cagA positive H. pylori infection suggests that the bacterium has an etiologic role in both diffuse-type and intestinal-type gastric carcinoma.",
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author = "Massimo Rugge and Graziella Busatto and Mauro Cassaro and Shiao, {Yih Horng} and Valentina Russo and Gioacchino Leandro and Claudio Avellini and Alfredo Fabiano and Angelo Sidoni and Antonello Covacci",
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T2 - Helicobacter pylori genotype and associated gastritis phenotype

AU - Rugge, Massimo

AU - Busatto, Graziella

AU - Cassaro, Mauro

AU - Shiao, Yih Horng

AU - Russo, Valentina

AU - Leandro, Gioacchino

AU - Avellini, Claudio

AU - Fabiano, Alfredo

AU - Sidoni, Angelo

AU - Covacci, Antonello

PY - 1999/6/15

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N2 - BACKGROUND. In the general population, Helicobacter pylori (H. pylori), particularly the cagA positive strain, has been associated with intestinal- type gastric carcinoma. Gastric carcinomas are rarely observed in patients age ≤40 years. Host-related factors have been thought to be more important than environmental agents in these early-onset cancers. The aim of this study was to ascertain the possible role of H. pylori infection and that of cagA positive strains in the development of gastric carcinoma in these young patients. METHODS. In this case-control study, 105 gastric carcinoma patients (male-to-female ratio = 1.1; mean age, 34.4 years; range, 16-40 years) and an equal number of controls (matched for gender and age) were retrospectively selected from the same geographic area. The phenotypes of gastritis and H. pylori were histologically assessed, and the presence of the ureC gene, which is indicative of H. pylori infection, and the cagA genotype were determined by polymerase chain reaction. Gastric carcinoma risk was calculated by both univariate and multivariate statistical methods, taking into account the cancer phenotype, the gastritis phenotype detected in both patients and controls, and the H. pylori genotype. RESULTS. For 74 diffuse and 31 intestinal gastric carcinomas, multivariate logistic regression analysis produced results consistent with those of univariate statistical tests, showing a significant association between gastric carcinoma and both H. pylori infection (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.52-5.11) and cagA positive status (OR = 2.94; 95% CI = 1.56-5.52). CONCLUSIONS. In young Italian patients with gastric carcinoma, the significant association with cagA positive H. pylori infection suggests that the bacterium has an etiologic role in both diffuse-type and intestinal-type gastric carcinoma.

AB - BACKGROUND. In the general population, Helicobacter pylori (H. pylori), particularly the cagA positive strain, has been associated with intestinal- type gastric carcinoma. Gastric carcinomas are rarely observed in patients age ≤40 years. Host-related factors have been thought to be more important than environmental agents in these early-onset cancers. The aim of this study was to ascertain the possible role of H. pylori infection and that of cagA positive strains in the development of gastric carcinoma in these young patients. METHODS. In this case-control study, 105 gastric carcinoma patients (male-to-female ratio = 1.1; mean age, 34.4 years; range, 16-40 years) and an equal number of controls (matched for gender and age) were retrospectively selected from the same geographic area. The phenotypes of gastritis and H. pylori were histologically assessed, and the presence of the ureC gene, which is indicative of H. pylori infection, and the cagA genotype were determined by polymerase chain reaction. Gastric carcinoma risk was calculated by both univariate and multivariate statistical methods, taking into account the cancer phenotype, the gastritis phenotype detected in both patients and controls, and the H. pylori genotype. RESULTS. For 74 diffuse and 31 intestinal gastric carcinomas, multivariate logistic regression analysis produced results consistent with those of univariate statistical tests, showing a significant association between gastric carcinoma and both H. pylori infection (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.52-5.11) and cagA positive status (OR = 2.94; 95% CI = 1.56-5.52). CONCLUSIONS. In young Italian patients with gastric carcinoma, the significant association with cagA positive H. pylori infection suggests that the bacterium has an etiologic role in both diffuse-type and intestinal-type gastric carcinoma.

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KW - Diffuse-type gastric carcinoma

KW - Environmental gastric carcinoma

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KW - Helicobacter pylori

KW - Intestinal-type gastric carcinoma

KW - Multifocal atrophic gastritis

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