Open AccessCharacteristics of non-cardia gastric cancer with a high serum anti-Helicobacter pylori IgG titer and its association with diffuse-type histology
Author(s) -
Eun Jeong Gong,
Ji Young Lee,
Suh Eun Bae,
Young Soo Park,
Kee Don Choi,
Ho June Song,
Gin Hyug Lee,
HwoonYong Jung,
Woo Jin Jeong,
Gab Jin Cheon,
Jeong Hwan Yook,
Byung Sik Kim
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0195264
Subject(s) - titer , helicobacter pylori , gastroenterology , medicine , univariate analysis , cancer , histology , antibody , multivariate analysis , immunology
Background Data on implications of a high positive titer of serum anti- Helicobacter pylori antibody on gastric cancer (GC) is limited. This study aimed to investigate the characteristics of GC with a high serum anti- H . pylori IgG (Hp-IgG) titer, and its association with diffuse-type GC. Methods We analyzed clinical and histological characteristics of 917 non-cardia GC patients who underwent gastrectomy. H . pylori infection was determined serologically by measuring Hp-IgG titer with immunoassay. Seropositive patients were divided into three groups (low-positive, mid-positive, and high-positive) according to the Hp-IgG titer value. Tumors were classified according to the Lauren criteria as diffuse or intestinal types. Results The median age of the patients was 59.0 years, and 33.8% were female. The patents were grouped as follows: seronegative, 188 (20.5%); low-positive, 288 (31.4%); mid-positive, 290 (31.6%); and high-positive 151 (16.5%). The high-positive group was significantly younger (median age, 55.0 years), with a higher proportion of female (45.0%) and non-smokers (58.9%). The proportion of diffuse-type GC increased in the order low-, mid-, and high-positive groups ( p <0.001). In univariate analysis, the factors associated with diffuse-type GC were younger age, female sex, non-smokers, and a high-positive Hp-IgG titer. Younger age, female sex, and non-smokers remained significant on multivariate analysis whereas the high-positive Hp-IgG titer showed only a tendency toward the association ( p = 0.078). Conclusions Non-cardia GC patients with a high Hp-IgG titer have distinct clinicopathologic characteristics. A high-positive Hp-IgG titer should be interpreted together with patients’ age, sex, and smoking status.