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Background  The  vacA ,  cagA  and  babA2  genotypes of  Helicobacter pylori  are associated with gastric pathology. The objectives were to determine the frequency of infection and distribution of the  vacA ,  cagA  and  babA2  genotypes of  H. pylori  in patients with gastric ulcer, chronic gastritis and gastric cancer, and to evaluate the association of virulent genotypes with diagnosis.    Methods  We studied 921 patients with symptoms of dyspepsia or with presumptive diagnosis of gastric cancer. The DNA of  H. pylori  and the  vacA ,  cagA  and  babA2  genes was detected by PCR in total DNA from gastric biopsies. The association of  H. pylori  and of its  cagA ,  vacA  and  babA2  genotypes with diagnosis was determined by calculating the odds ratio (OR).    Results  Chronic gastritis was confirmed in 767 patients, gastric ulcer in 115 and cancer in 39. The prevalence of  H. pylori  was 47.8, 49.6 and 61.5% in those groups, respectively.  H. pylori  was more frequent in the surrounding tissue (69.2%) than in the tumor (53.8%). The  vacA s1m1  genotype predominated in the three groups (45.2, 61.4 and 83.3%, respectively).  H. pylori  was associated with cancer (OR adjusted  = 2.08; 95% CI 1.05–4.13;  p  = 0.035) but not with ulcer (OR adjusted  = 1.07; 95% CI 0.71–1.61;  p  = 0.728). The  s1m1  genotype was associated with ulcer and cancer (OR adjusted  = 2.02; 95% CI 1.12–3.62;  p  = 0.019 and OR adjusted  = 6.58; 95% CI 2.15–20.08;  p  = 0.001, respectively).  babA2  was associated with gastric cancer, and  cagA  was not associated with the diagnosis.    Conclusions  In population from Southern Mexico,  H. pylori  and the  s1m1  genotype were associated with gastric cancer and the  s1m1 / cagA +/ babA2 + strains predominated in tumor and adjacent tissue.

Helicobacter pylori vacA s1m1 genotype but not cagA or babA2 increase the risk of ulcer and gastric cancer in patients from Southern Mexico