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Patients younger than 40 years with gastric carcinoma
Author(s) -
Rugge Massimo,
Busatto Graziella,
Cassaro Mauro,
Shiao YihHorng,
Russo Valentina,
Leandro Gioacchino,
Avellini Claudio,
Fabiano Alfredo,
Sidoni Angelo,
Covacci Antonello
Publication year - 1999
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19990615)85:12<2506::aid-cncr3>3.0.co;2-i
Subject(s) - caga , odds ratio , helicobacter pylori , medicine , gastroenterology , univariate analysis , confidence interval , cancer , gastritis , carcinoma , population , multivariate analysis , genotype , biology , gene , genetics , environmental health , virulence
BACKGROUND In the general population, Helicobacter pylori ( H. pylori ), particularly the cagA positive strain, has been associated with intestinal‐type gastric carcinoma. Gastric carcinomas are rarely observed in patients age ≤40 years. Host‐related factors have been thought to be more important than environmental agents in these early‐onset cancers. The aim of this study was to ascertain the possible role of H. pylori infection and that of cagA positive strains in the development of gastric carcinoma in these young patients. METHODS In this case−control study, 105 gastric carcinoma patients (male‐to‐female ratio = 1.1; mean age, 34.4 years; range, 16−40 years) and an equal number of controls (matched for gender and age) were retrospectively selected from the same geographic area. The phenotypes of gastritis and H. pylori were histologically assessed, and the presence of the ureC gene, which is indicative of H. pylori infection, and the cagA genotype were determined by polymerase chain reaction. Gastric carcinoma risk was calculated by both univariate and multivariate statistical methods, taking into account the cancer phenotype, the gastritis phenotype detected in both patients and controls, and the H. pylori genotype. RESULTS For 74 diffuse and 31 intestinal gastric carcinomas, multivariate logistic regression analysis produced results consistent with those of univariate statistical tests, showing a significant association between gastric carcinoma and both H. pylori infection (odds ratio [OR] = 2.79; 95% confidence interval [CI] = 1.52−5.11) and cagA positive status (OR = 2.94; 95% CI = 1.56−5.52). CONCLUSIONS In young Italian patients with gastric carcinoma, the significant association with cagA positive H. pylori infection suggests that the bacterium has an etiologic role in both diffuse‐type and intestinal‐type gastric carcinoma. Cancer 1999;85:2506–11. © 1999 American Cancer Society.