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Frequency of Helicobacter pylori and CagA Antibody in Patients with Gastric Neoplasms and Controls: The Indian Enigma

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Abstract

Background Despite association between H. pylori and gastric neoplasm (GN) from the developed world, studies from India, where infection is more common and acquired early, are scant and contradictory. Methods Two hundred and seventy-nine patients with GN from two northern and one eastern Indian centers during the period 1997–2005, 101 non-ulcer dyspepsia (NUD), and 355 healthy volunteers (HV) were evaluated for H. pylori [rapid urease test (RUT), histology and anti-H. pylori, and CagA IgG serology]. Results Patients with GN [263 gastric carcinoma and 16 (6%) primary gastric lymphoma, 208 male] were older than HV (n = 355, 188 male) and NUD (n = 101, 54 male) patients (53 ± 12 versus 44 ± 17 and 43 ± 13 years, respectively; P < 0.001). Eastern Indian patients with GN (n = 145) were younger than those from northern India (n = 134; 52 ± 12 versus 55 ± 12 years; P < 0.007, t-test). In GN and NUD patients H. pylori positivity by RUT [86/225 (38%) versus 46/101 (46%)], anti-H. pylori IgG [154/198 (78%) versus 85/101 (84%)], and histology [136/213 (64%) versus 55/101 (55%)] were comparable (χ 2-test). Serum IgG anti-H. pylori antibody was more common among HV than among GN patients [300/355 (85%) versus 154/198 (78%); P = 0.04, χ 2-test]. Intestinal metaplasia was more common in GN than in NUD patients [101/252 (40%) versus 2/98 (2%), P < 0.000, χ 2-test]. CagAIgG was more common in GN than in NUD patients [124/163 (76%) versus 64/101 (63%)] but comparable to that in HV patients [87/98 (89%), P = NS]. Conclusion Frequency of H. pylori as detected using endoscopy and serology-based tests is not higher among patients with GN as compared with controls in India.

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Acknowledgments

This work was supported by a grant from The Indian Council of Medical Research to UCG (No. 5/4/3-5/03/99-NCD-II). This article is dedicated to Prof. S. R. Naik, who was a co-investigator in this project. He passed away on July 1, 2002.

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Authors and Affiliations

  1. Departments of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Uday C. Ghoshal, Shridhar Tiwari, Shweta Tripathi & Himani Singh

  2. Departments of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Sadhna Dhingra & Rakesh Pandey

  3. Departments of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Ujjala Ghoshal & Archana Ayyagari

  4. Department of Gastroenterology, Central Command, Lucknow, India

    V. K. Gupta & A. K. Nagpal

  5. Departments of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, India

    Sita Naik

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  1. Uday C. Ghoshal
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Ghoshal, U.C., Tiwari, S., Dhingra, S. et al. Frequency of Helicobacter pylori and CagA Antibody in Patients with Gastric Neoplasms and Controls: The Indian Enigma. Dig Dis Sci 53, 1215–1222 (2008). https://doi.org/10.1007/s10620-008-0229-7

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