Helicobacter pylori is a bacteria with high genome plasticity that has been associated with diverse gastric pathologies. The genetic diversity of this bacteria has limited the characterization of virulence factors associated with gastric cancer (GC). To identify potentially helpful disease biomarkers, we compared 38 complete genomes and 108 draft genomes of H. pylori isolated worldwide from patients with diverse gastric pathologies and 53 draft genomes of H. pylori isolated from Mexican patients with GC, intestinal metaplasia, gastritis, peptic ulcer, and dyspepsia. H. pylori strains isolated from GC were 3–11 times more likely to harbor any of seven genes encoded within an integrative and conjugative element (ICE) than H. pylori isolated from subjects with other gastric pathologies. We tested the cytopathic effects on AGS cells of selected H. pylori strains with known cytotoxin-associated gene pathogenicity island (cag-PAI) and ICE status (H. pylori strains 29CaP, 29CaCe, 62A9, 7C, 8822, and 26695) and the histopathological damage of H. pylori 29CaP and 62A9 in a mouse model. H. pylori 29CaP, which harbors a complete ICEHptfs3 but lacks cag-PAI, elicited distinctive morphology changes and higher histopathological scores compared with other H. pylori strains carrying cag-PAI and hybrid ICE with incomplete TFSS. The presence of intact segments of ICE regions might be a risk factor to develop GC that needs to be addressed in future studies.

幽门螺杆菌是一种具有高基因组可塑性的细菌，与多种胃病理有关。这种细菌的遗传多样性限制了与胃癌（GC）相关的毒力因子的表征。为了识别潜在有用的疾病生物标志物，我们比较了 38 个完整基因组和 108 个基因组草图。幽门螺杆菌在全球范围内从患有不同胃病的患者中分离出来，并获得了 53 个基因组草图幽门螺杆菌从患有GC、肠化生、胃炎、消化性溃疡和消化不良的墨西哥患者中分离出来。幽门螺杆菌从 GC 分离的菌株携带整合和接合元件 (ICE) 内编码的 7 个基因中的任何一个的可能性比从 GC 分离的菌株高 3-11 倍幽门螺杆菌从患有其他胃病的受试者中分离出来。我们测试了选定的 AGS 细胞的细胞病变效应幽门螺杆菌具有已知细胞毒素相关基因致病岛的菌株（卡格-PAI）和 ICE 状态（幽门螺杆菌菌株 29CaP、29CaCe、62A9、7C、8822 和 26695）以及组织病理学损伤幽门螺杆菌小鼠模型中的 29CaP 和 62A9。幽门螺杆菌29CaP，拥有完整的ICEHptfs3，但缺乏卡格-与其他药物相比，PAI 引起了独特的形态学变化和更高的组织病理学评分幽门螺杆菌携带菌株卡格-具有不完整TFSS的PAI和混合ICE。ICE 区域完整片段的存在可能是发生 GC 的一个风险因素，需要在未来的研究中解决。