Characteristics of non-cardia gastric cancer with a high serum anti-Helicobacter pylori IgG titer and its association with diffuse-type histology

Abstract

BackgroundData 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.MethodsWe 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.ResultsThe 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).ConclusionsNon-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.

Bioinformatics analysis identifies biomarkers associated with poor prognosis in diffuse‑type gastric cancer

“…Epidemiologically, intestinal GC is the most common type, has the highest five-year survival rate, and is more common in men and the elderly. Diffuse-type GC is more likely in women and younger patients and has a lower 5-year survival rate (10)(11)(12). Mix-type has the highest degree of malignancy due to variable biological behavior (13).…”

Prognostic value and association of Lauren classification with VEGF and VEGFR‑2 expression in gastric cancer

“…Mix-type GC possesses all these characteristics (3). The proportion of men and elderly patients is higher in intestinal-type GC, whereas diffuse-type GC is more likely to happen in women and younger patients (4,5). Lauren classification presents differences in etiology, epidemiology and pathology, which means that certain tumor development pathways are characteristics of different Lauren classifications (4,6,7).…”

Diffuse Gastric Cancer: A Summary of Analogous Contributing Factors for Its Molecular Pathogenicity

“…Several other studies have also reported the association of H. pylori infection with the development of DGC [ 120 , 121 , 122 ]. A recent study reported that patients with current infections were prone to developing DGC compared to patients with past infections [ 123 , 124 ]. Similarly, the association of H. pylori was found in 85.36% of DGC [ 125 ].…”

“…The progression of gastric mucosal atrophy associated with a decrease in H. pylori titer may be attributable to the association between past infection or low H. pylori -IgG titer and IGC [ 123 ]. Gong et al also reported the association of high H. pylori -IgG titer with the development of DGC [ 124 ].…”