Helicobacter pylori multiplex serology and risk of non-cardia and cardia gastric cancer: a case-cohort study and meta-analysis,International Journal of Epidemiology

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Helicobacter pylori multiplex serology and risk of non-cardia and cardia gastric cancer: a case-cohort study and meta-analysis
International Journal of Epidemiology ( IF 6.4 ) Pub Date : 2023-03-13 , DOI: 10.1093/ije/dyad007
Pang Yao ₁ , Christiana Kartsonaki _{1,

2} , Julia Butt ₃ , Rima Jeske ₃ , Catherine de Martel ₄ , Martyn Plummer ₅ , Yu Guo ₆ , Sarah Clark _{1,

2} , Robin G Walters _{1,

2} , Yiping Chen _{1,

2} , Daniel Avery ₁ , Jun Lv _{7,

8} , Canqing Yu _{7,

8} , Hao Wang ₉ , Michael Hill _{1,

2} , Richard Peto ₁ , Liming Li _{7,

8} , Tim Waterboer ₃ , Zhengming Chen _{1,

2} , Iona Y Millwood _{1,

2} , Ling Yang _{1,

2}

Affiliation

Background Helicobacter pylori infection is a major cause of non-cardia gastric cancer (NCGC), but uncertainty remains about the associations between sero-positivity to different H. pylori antigens and risk of NCGC and cardia gastric cancer (CGC) in different populations. Methods A case-cohort study in China included ∼500 each of incident NCGC and CGC cases and ∼2000 subcohort participants. Sero-positivity to 12 H. pylori antigens was measured in baseline plasma samples using a multiplex assay. Hazard ratios (HRs) of NCGC and CGC for each marker were estimated using Cox regression. These were further meta-analysed with studies using same assay. Results In the subcohort, sero-positivity for 12 H. pylori antigens varied from 11.4% (HpaA) to 70.8% (CagA). Overall, 10 antigens showed significant associations with risk of NCGC (adjusted HRs: 1.33 to 4.15), and four antigens with CGC (HRs: 1.50 to 2.34). After simultaneous adjustment for other antigens, positive associations remained significant for NCGC (CagA, HP1564, HP0305) and CGC (CagA, HP1564, HyuA). Compared with CagA sero-positive only individuals, those who were positive for all three antigens had an adjusted HR of 5.59 (95% CI 4.68–6.66) for NCGC and 2.17 (95% CI 1.54–3.05) for CGC. In the meta-analysis of NCGC, the pooled relative risk for CagA was 2.96 (95% CI 2.58–3.41) [Europeans: 5.32 (95% CI 4.05–6.99); Asians: 2.41 (95% CI 2.05–2.83); Pheterogeneity<0.0001]. Similar pronounced population differences were also evident for GroEL, HP1564, HcpC and HP0305. In meta-analyses of CGC, two antigens (CagA, HP1564) were significantly associated with a higher risk in Asians but not Europeans. Conclusions Sero-positivity to several H. pylori antigens was significantly associated with an increased risk of NCGC and CGC, with varying effects between Asian and European populations.

更新日期：2023-03-13

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