Background-Helicobacter pylori species comprise diVerent strains, cytotoxic and non-cytotoxic, which can be identified on the basis of their genomic pattern. Aims-(1) To evaluate the polymorphism of the vacA gene and to ascertain whether the cagA gene is present in patients with gastric adenocarcinoma. (2) To study the anti-H pylori antibody profile using western blotting. Patients-Twenty one patients with gastric adenocarcinoma and 71 with H pylori associated benign disease (nine gastric ulcer, 29 duodenal ulcer, 25 antral gastritis, and eight duodenitis). Methods-The polymerase chain reaction was used to verify the presence or absence of cagA and to study the polymorphism of vacA in gastric mucosal samples obtained during endoscopy for patients with benign diseases and at surgery for patients with gastric adenocarcinoma. Fasting sera were used to assess anti-H pylori antibodies against diVerent H pylori antigens by western blotting. Results-cagA gene and the allele s1 of vacA were significantly less frequent in patients with antral gastritis (60% and 60%) compared with patients with gastric adenocarcinoma (94% and 100%) and with other non-malignant gastroduodenal diseases (93% and 87%) ( 2 =16.01, p<0.001; and 2 =13.97, p<0.01). In patients with gastric adenocarcinoma, antibodies against a 74 kDa H pylori antigen were less frequently found than in patients with benign diseases. Conclusions-H pylori infection caused bycagA positive/vacA s1 strains is a frequent finding in patients with gastric adenocarcinoma. Prospective studies are needed to confirm whether the low incidence of positive serological response to the 74 kDa H pylori antigen in patients with gastric adenocarcinoma is important.

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Background. Cysteine proteases (cathepsin B [CATB] and cathepsin L [CATL]), the serine protease urokinasetype plasminogen activator (UPA), and plasminogen activator inhibitor type‐1 (PAI‐1) are thought to play an important part in cancer invasion and metastasis. The aims of this study were to measure CATB, CATL, UPA, and PAI‐1 in gastric cancer (GC) and normal mucosa distant from the tumor (NORM); to evaluate whether tissue levels are related to tumor stage, grade, or histotype; to assess their prognostic relevance; and to examine UPA and PAI‐1 expression immunohistochemically. Methods. Gastric cancer and NORM samples were obtained from 25 patients with gastric cancer patients undergoing surgery (17 males, 8 females; mean age, 62 years; range, 31–84 years). Antigen concentrations were measured using the enzyme‐linked immunosorbent assay method. Immunohistochemistry was performed using monoclonal UPA and PAI‐1 antibodies. Results. Significantly higher antigen levels were found: (1) in GC vs. NORM (CATB, CATL, UPA, PAI‐1) tissues; (2) in GC with versus without metastasis (CATB, CATL, UPA); (3) in poorly or moderately versus well differentiated GC; and (4) in diffuse versus intestinal‐type GC (CATB, CATL). Urokinase‐type plasminogen activator, PAI‐1 and CATB levels had a significant prognostic impact. Cancer and stromal cells, showed immunoreactivity to anti‐UPA and anti‐PAI‐1 antibodies. Conclusions. These results confirm the important role of CATB, CATL, UPA and PAI‐1 in gastric cancer progression. Higher levels are detected in GC with metastases, poorer differentiation, and diffuse histotype, thus identifying patients with a worse prognosis Cancer 1995; 76:367–75.