2007
DOI: 10.1093/jnci/djm120
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Helicobacter pylori Cytotoxin-Associated Genotype and Gastric Precancerous Lesions

Abstract: This large epidemiologic study shows a strong relationship between the presence of H. pylori DNA in gastric biopsies and the severity of precancerous lesions that is specific to cagA-positive strains. The association between H. pylori and gastric carcinoma may have been previously underestimated due to the poor accuracy of serologic H. pylori markers and lack of discrimination by cagA genotype.

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Cited by 99 publications
(81 citation statements)
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References 27 publications
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“…Because the vacA gene is present in all H. pylori strains, we used this marker to identify patients with H. pylori infection. 7,8 We emphasize that PCR analysis has been reported to be associated with a higher sensitivity when compared with other detection methods such as bacterial culture or histologic analysis. 18 Serologic positivity in our series (77%) was similar to the overall rate reported in a recent meta-analysis including a large number of gastric cancer patients.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Because the vacA gene is present in all H. pylori strains, we used this marker to identify patients with H. pylori infection. 7,8 We emphasize that PCR analysis has been reported to be associated with a higher sensitivity when compared with other detection methods such as bacterial culture or histologic analysis. 18 Serologic positivity in our series (77%) was similar to the overall rate reported in a recent meta-analysis including a large number of gastric cancer patients.…”
Section: Discussionmentioning
confidence: 99%
“…The clinical outcome of H. pylori infection may be because of several factors, such as age at the time of first infection, environmental factors, immune response, and genetic characteristics. 7 The vacA gene is present in all H. pylori strains and encodes the vacuolating cytotoxin VacA, which induces epithelial cell injury. The gene comprises 2 variable regions: m (middle region) and s (signal peptide).…”
mentioning
confidence: 99%
“…In fact, the presence of H. pylori DNA in gastric biopsies, the severity of precancerous lesions, and hence gastric cancer risk, appear to be specific of cagA positive strains. [35][36][37][38] Another important cause of stomach cancer is tobacco smoking. Smokers have a 50-60% increased risk of stomach cancer, as compared to nonsmokers.…”
Section: Discussionmentioning
confidence: 99%
“…If eradication is done too late, the point of no return for cancer risk may have passed in many individuals (59). Stratifying populations (60) and developing biomarkers that accurately predict risk (39,61) are critical to resolving this dilemma.…”
Section: Challenges Facing Cancer Preventive Interventionsmentioning
confidence: 99%
“…Progress in the field will require better clinical diagnostics to identify specific agents, specific microbial genotypes, specific host genotypes, and other critical factors of the host-microbe interaction (61,66,67). To eliminate the tendency for certain persistent microbes to push toward malignancies, we will need new pharmacologic approaches based on a better understanding of host-microbe interactions.…”
Section: The Futurementioning
confidence: 99%