PURPOSE:Currently, studies on serologic diagnosis of Helicobacter pylori-associated gastric cancer (GC) in Latin America are scarce. The aim of the present study was to evaluate the association between H. pylori serology tests in patients with early precancerous lesions or GC, when compared with non-atrophic gastritis in Colombia, Paraguay, and Mexico, three countries in Latin America with a high prevalence of H. pylori infection but contrasting rates of GC mortality. METHODS:Gastric biopsies and blood samples were obtained from patients attending the gastroenterology or oncology services of hospitals in the three participating countries. IgG antibodies against H. pylori whole-cell antigens and CagA were tested in 1,117 sera using an enzyme-linked immunoabsorbent assay. RESULTS:Positive and significant associations were shown for H. pylori seropositivity and preneoplastic lesions in Mexico (OR 2.0; 95 % CI 1.1-3.4) but not in Colombia (OR 1.2; 95 % CI 0.6-2.1) or Paraguay (OR 1.5; 95 % CI 0.6-3.2); no significant associations were shown for GC in any country. CagA seropositivity was associated with preneoplasic lesions in all three countries (ORs = 2.1, 3.0, and 3.1 for Mexico, Colombia, and Paraguay, respectively), and with GC only in Colombia (OR 4.3; 95 % CI 2.1-9.2). CONCLUSIONS:In countries of Latin America, the IgG CagA test might be a useful biomarker for patients with gastric preneoplastic lesions and for those at risk of developing gastric cancer.

译文

目的:目前,拉丁美洲缺乏关于幽门螺杆菌相关性胃癌(GC)的血清学诊断的研究。本研究的目的是,与哥伦比亚,巴拉圭和墨西哥这三个高流行率国家中的非萎缩性胃炎相比,评估具有早期癌前病变或GC的幽门螺杆菌血清学检测之间的相关性幽门螺杆菌感染的发生率,但GC死亡率却相反。
方法:从三个参与国医院的胃肠病学或肿瘤学服务的患者那里获取胃活检和血液样本。使用酶联免疫吸附试验在1117份血清中测试了针对幽门螺杆菌全细胞抗原和CagA的IgG抗体。
结果:在墨西哥(OR 2.0; 95%CI 1.1-3.4)或哥伦比亚(OR 1.2; 95%CI 0.6-2.1)或巴拉圭(OR 1.5;墨西哥; OR);幽门螺杆菌血清阳性和肿瘤前病变的阳性和显着相关性。 95%CI 0.6-3.2);在任何国家/地区,GC均未显示任何重要关联。在所有三个国家中,CagA血清阳性与肿瘤前病变有关(墨西哥,哥伦比亚和巴拉圭的OR分别为2.1、3.0和3.1),仅在哥伦比亚与GC相关(OR 4.3; 95%CI 2.1-9.2)。
结论:在拉丁美洲国家,IgG CagA检测对于胃癌前病变和有患胃癌风险的患者可能是有用的生物标志物。

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