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 journalArticlepeer-review

3 Citations (Scopus)
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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 languageEnglish
Article number205
Number of pages10
JournalFrontiers in oncology
Volume10
DOIs
Publication statusPublished - 03 Mar 2020
Externally publishedYes

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

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