Helicobacter pylori Is Associated With Precancerous and Cancerous Lesions of the Gastric Cardia Mucosa: Results of a Large Population-Based Study in China

Shuanghua Xie; Shaoming Wang; Liyan Xue; Daniel R.S. Middleton; Chentao Guan; Changqing Hao; Jinwu Wang; Bianyun Li; Ru Chen; Xinqing Li; Wenqiang Wei

doi:10.3389/fonc.2020.00205

Helicobacter pylori Is Associated With Precancerous and Cancerous Lesions of the Gastric Cardia Mucosa: Results of a Large Population-Based Study in China

Shuanghua Xie, Shaoming Wang, Liyan Xue, Daniel R.S. Middleton, Chentao Guan, Changqing Hao, Jinwu Wang, Bianyun Li, Ru Chen, Xinqing Li, Wenqiang Wei^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Helicobacter pylori (H. pylori) is widely accepted to be the most important cause of gastric non-cardia adenocarcinoma (GNCA), while its role in the development of gastric cardia adenocarcinoma (GCA) is not well-defined. We aimed to investigate current H. pylori infection in relation to the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. Methods: A population-based cross-sectional study was conducted in Linzhou County, Henan Province, China. Two thousand three (2,003) randomly selected participants with data on current H. pylori infection, assayed by ¹³C-urea breath test (¹³C-UBT), and a sequence of histological diagnoses of the gastric cardia mucosa were analyzed. Results: Of 2,003 subjects, 828 (41.33%) were currently infected with H. pylori. The prevalence of current H. pylori infection increased with increasing severity of histological lesions, from 34.12% in subjects with normal gastric cardia mucosa to 52.17% in subjects with gastric cardia high-grade intraepithelial neoplasia (CHIN)/ gastric cardia adenocarcinoma (GCA) (P for trend <0.001). With H. pylori-negative subjects as the reference category, H. pylori-positive subjects had statistically significant elevated adjusted prevalence odds ratios (PORs) for each of the histological lesions. The PORs (95% CI) were 2.15 (1.74–2.64), 3.46 (2.08–5.75), 2.78 (1.90–4.07), and 3.05 (1.30–7.17) for subjects with carditis, cardia intestinal metaplasia (CIM), cardia low-grade intraepithelial neoplasia (CLIN), and CHIN/GCA), respectively. The associations remained when subjects with abnormal stomach non-cardia mucosa were excluded. Conclusions: This large epidemiologic study demonstrates a positive association between current H. pylori infection and the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. These findings suggest that H. pylori infection may play a role throughout both early- and late-stage development of GCA.

Original language	English
Article number	205
Number of pages	10
Journal	Frontiers in Oncology
Volume	10
DOIs	https://doi.org/10.3389/fonc.2020.00205
Publication status	Published - 03 Mar 2020
Externally published	Yes

Bibliographical note

Funding Information:
This work was supported by grants from the National Key R&D Program of China (Grant Nos: 2016YFC0901400 and 2016YFC0901404); the National Natural Science Fund (Grant No: 81974493), and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (Grant No: 2016-I2M-3-001).

Funding Information:
The authors would like to thank the team of National Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, and all physicians and researchers in Linzhou working on the present study for their efforts on the study. We would also appreciate the residents in Linzhou for their cooperation with the research. Funding. This work was supported by grants from the National Key R&D Program of China (Grant Nos: 2016YFC0901400 and 2016YFC0901404); the National Natural Science Fund (Grant No: 81974493), and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (Grant No: 2016-I2M-3-001).

Publisher Copyright:
© Copyright © 2020 Xie, Wang, Xue, Middleton, Guan, Hao, Wang, Li, Chen, Li and Wei.

Keywords

C-urea breath test
gastric cardia
gastric cardia adenocarcinoma
Helicobacter pylori
population-based studies
precursor lesions

ASJC Scopus subject areas

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Helicobacter pylori Is Associated With Precancerous and Cancerous Lesions of the Gastric Cardia Mucosa: Results of a Large Population-Based Study in China
© 2020 The Authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.13 MBLicence: CC BY

Cite this

@article{e68f3fcc37e341b2bfa8a81520210b89,

title = "Helicobacter pylori Is Associated With Precancerous and Cancerous Lesions of the Gastric Cardia Mucosa: Results of a Large Population-Based Study in China",

abstract = "Background: Helicobacter pylori (H. pylori) is widely accepted to be the most important cause of gastric non-cardia adenocarcinoma (GNCA), while its role in the development of gastric cardia adenocarcinoma (GCA) is not well-defined. We aimed to investigate current H. pylori infection in relation to the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. Methods: A population-based cross-sectional study was conducted in Linzhou County, Henan Province, China. Two thousand three (2,003) randomly selected participants with data on current H. pylori infection, assayed by 13C-urea breath test (13C-UBT), and a sequence of histological diagnoses of the gastric cardia mucosa were analyzed. Results: Of 2,003 subjects, 828 (41.33%) were currently infected with H. pylori. The prevalence of current H. pylori infection increased with increasing severity of histological lesions, from 34.12% in subjects with normal gastric cardia mucosa to 52.17% in subjects with gastric cardia high-grade intraepithelial neoplasia (CHIN)/ gastric cardia adenocarcinoma (GCA) (P for trend <0.001). With H. pylori-negative subjects as the reference category, H. pylori-positive subjects had statistically significant elevated adjusted prevalence odds ratios (PORs) for each of the histological lesions. The PORs (95% CI) were 2.15 (1.74–2.64), 3.46 (2.08–5.75), 2.78 (1.90–4.07), and 3.05 (1.30–7.17) for subjects with carditis, cardia intestinal metaplasia (CIM), cardia low-grade intraepithelial neoplasia (CLIN), and CHIN/GCA), respectively. The associations remained when subjects with abnormal stomach non-cardia mucosa were excluded. Conclusions: This large epidemiologic study demonstrates a positive association between current H. pylori infection and the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. These findings suggest that H. pylori infection may play a role throughout both early- and late-stage development of GCA.",

keywords = "C-urea breath test, gastric cardia, gastric cardia adenocarcinoma, Helicobacter pylori, population-based studies, precursor lesions",

author = "Shuanghua Xie and Shaoming Wang and Liyan Xue and Middleton, {Daniel R.S.} and Chentao Guan and Changqing Hao and Jinwu Wang and Bianyun Li and Ru Chen and Xinqing Li and Wenqiang Wei",

note = "Funding Information: This work was supported by grants from the National Key R&D Program of China (Grant Nos: 2016YFC0901400 and 2016YFC0901404); the National Natural Science Fund (Grant No: 81974493), and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (Grant No: 2016-I2M-3-001). Funding Information: The authors would like to thank the team of National Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, and all physicians and researchers in Linzhou working on the present study for their efforts on the study. We would also appreciate the residents in Linzhou for their cooperation with the research. Funding. This work was supported by grants from the National Key R&D Program of China (Grant Nos: 2016YFC0901400 and 2016YFC0901404); the National Natural Science Fund (Grant No: 81974493), and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (Grant No: 2016-I2M-3-001). Publisher Copyright: {\textcopyright} Copyright {\textcopyright} 2020 Xie, Wang, Xue, Middleton, Guan, Hao, Wang, Li, Chen, Li and Wei.",

year = "2020",

month = mar,

day = "3",

doi = "10.3389/fonc.2020.00205",

language = "English",

volume = "10",

journal = "Frontiers in Oncology",

issn = "2234-943X",

publisher = "Frontiers Media S.A.",

}

TY - JOUR

T1 - Helicobacter pylori Is Associated With Precancerous and Cancerous Lesions of the Gastric Cardia Mucosa: Results of a Large Population-Based Study in China

AU - Xie, Shuanghua

AU - Wang, Shaoming

AU - Xue, Liyan

AU - Middleton, Daniel R.S.

AU - Guan, Chentao

AU - Hao, Changqing

AU - Wang, Jinwu

AU - Li, Bianyun

AU - Chen, Ru

AU - Li, Xinqing

AU - Wei, Wenqiang

N1 - Funding Information: This work was supported by grants from the National Key R&D Program of China (Grant Nos: 2016YFC0901400 and 2016YFC0901404); the National Natural Science Fund (Grant No: 81974493), and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (Grant No: 2016-I2M-3-001). Funding Information: The authors would like to thank the team of National Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, and all physicians and researchers in Linzhou working on the present study for their efforts on the study. We would also appreciate the residents in Linzhou for their cooperation with the research. Funding. This work was supported by grants from the National Key R&D Program of China (Grant Nos: 2016YFC0901400 and 2016YFC0901404); the National Natural Science Fund (Grant No: 81974493), and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences (Grant No: 2016-I2M-3-001). Publisher Copyright: © Copyright © 2020 Xie, Wang, Xue, Middleton, Guan, Hao, Wang, Li, Chen, Li and Wei.

PY - 2020/3/3

Y1 - 2020/3/3

N2 - Background: Helicobacter pylori (H. pylori) is widely accepted to be the most important cause of gastric non-cardia adenocarcinoma (GNCA), while its role in the development of gastric cardia adenocarcinoma (GCA) is not well-defined. We aimed to investigate current H. pylori infection in relation to the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. Methods: A population-based cross-sectional study was conducted in Linzhou County, Henan Province, China. Two thousand three (2,003) randomly selected participants with data on current H. pylori infection, assayed by 13C-urea breath test (13C-UBT), and a sequence of histological diagnoses of the gastric cardia mucosa were analyzed. Results: Of 2,003 subjects, 828 (41.33%) were currently infected with H. pylori. The prevalence of current H. pylori infection increased with increasing severity of histological lesions, from 34.12% in subjects with normal gastric cardia mucosa to 52.17% in subjects with gastric cardia high-grade intraepithelial neoplasia (CHIN)/ gastric cardia adenocarcinoma (GCA) (P for trend <0.001). With H. pylori-negative subjects as the reference category, H. pylori-positive subjects had statistically significant elevated adjusted prevalence odds ratios (PORs) for each of the histological lesions. The PORs (95% CI) were 2.15 (1.74–2.64), 3.46 (2.08–5.75), 2.78 (1.90–4.07), and 3.05 (1.30–7.17) for subjects with carditis, cardia intestinal metaplasia (CIM), cardia low-grade intraepithelial neoplasia (CLIN), and CHIN/GCA), respectively. The associations remained when subjects with abnormal stomach non-cardia mucosa were excluded. Conclusions: This large epidemiologic study demonstrates a positive association between current H. pylori infection and the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. These findings suggest that H. pylori infection may play a role throughout both early- and late-stage development of GCA.

AB - Background: Helicobacter pylori (H. pylori) is widely accepted to be the most important cause of gastric non-cardia adenocarcinoma (GNCA), while its role in the development of gastric cardia adenocarcinoma (GCA) is not well-defined. We aimed to investigate current H. pylori infection in relation to the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. Methods: A population-based cross-sectional study was conducted in Linzhou County, Henan Province, China. Two thousand three (2,003) randomly selected participants with data on current H. pylori infection, assayed by 13C-urea breath test (13C-UBT), and a sequence of histological diagnoses of the gastric cardia mucosa were analyzed. Results: Of 2,003 subjects, 828 (41.33%) were currently infected with H. pylori. The prevalence of current H. pylori infection increased with increasing severity of histological lesions, from 34.12% in subjects with normal gastric cardia mucosa to 52.17% in subjects with gastric cardia high-grade intraepithelial neoplasia (CHIN)/ gastric cardia adenocarcinoma (GCA) (P for trend <0.001). With H. pylori-negative subjects as the reference category, H. pylori-positive subjects had statistically significant elevated adjusted prevalence odds ratios (PORs) for each of the histological lesions. The PORs (95% CI) were 2.15 (1.74–2.64), 3.46 (2.08–5.75), 2.78 (1.90–4.07), and 3.05 (1.30–7.17) for subjects with carditis, cardia intestinal metaplasia (CIM), cardia low-grade intraepithelial neoplasia (CLIN), and CHIN/GCA), respectively. The associations remained when subjects with abnormal stomach non-cardia mucosa were excluded. Conclusions: This large epidemiologic study demonstrates a positive association between current H. pylori infection and the severity of both precancerous and cancerous lesions of the gastric cardia in an Asian population at high risk of GCA. These findings suggest that H. pylori infection may play a role throughout both early- and late-stage development of GCA.

KW - C-urea breath test

KW - gastric cardia

KW - gastric cardia adenocarcinoma

KW - Helicobacter pylori

KW - population-based studies

KW - precursor lesions

U2 - 10.3389/fonc.2020.00205

DO - 10.3389/fonc.2020.00205

M3 - Article

AN - SCOPUS:85082662007

VL - 10

JO - Frontiers in Oncology

JF - Frontiers in Oncology

SN - 2234-943X

M1 - 205

ER -

Helicobacter pylori Is Associated With Precancerous and Cancerous Lesions of the Gastric Cardia Mucosa: Results of a Large Population-Based Study in China

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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