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cohort·epidemiology, oncology, gastroenterology, infectious disease, public health·PMC10396410

Helicobacter pylori multiplex serology and risk of non-cardia and cardia gastric cancer: a case-cohort study and meta-analysis

International Journal of Epidemiology · 21 authors, 32 centres

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TL;DR

This prospective case-cohort study in China measured sero-positivity to 12 H. pylori antigens and found that multiple antigens, especially CagA, HP1564, and HP0305, were significantly associated with increased risk of non-cardia gastric cancer, with CagA also associated with cardia gastric cancer risk.

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Sero-positivity to 12 H. pylori antigens was measured in baseline plasma samples using a multiplex assay, and hazard ratios were estimated using Cox regression. In the subcohort, sero-positivity varied from 11.4% (HpaA) to 70.8% (CagA). After simultaneous adjustment, CagA, HP1564, and HP0305 remained significant for NCGC, and CagA, HP1564, and HyuA for CGC. A meta-analysis of eight studies found the pooled relative risk for CagA and NCGC was 2.96, with more than twice as strong an effect in Europeans as in Asians.

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cohort

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epidemiology

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ORIGINAL PAPER

PMC10396410

Helicobacter pylori multiplex serology and risk of non-cardia and cardia gastric cancer: a case-cohort study and meta-analysis

International Journal of Epidemiology

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ABSTRACT

Abstract Background Helicobacter pylori infection is a major cause of non-cardia gastric cancer (NCGC), but uncertainty remains about the associations between sero-positivity to different H. pylori antigens and risk of NCGC and cardia gastric cancer (CGC) in different populations. Methods A case-cohort study in China included ∼500 each of incident NCGC and CGC cases and ∼2000 subcohort participants. Sero-positivity to 12 H. pylori antigens was measured in baseline plasma samples using a multiplex assay. Hazard ratios (HRs) of NCGC and CGC for each marker were estimated using Cox regression. These were further meta-analysed with studies using same assay. Results In the subcohort, sero-positivity for 12 H. pylori antigens varied from 11.4% (HpaA) to 70.8% (CagA). Overall, 10 antigens showed significant associations with risk of NCGC (adjusted HRs: 1.33 to 4.15), and four antigens with CGC (HRs: 1.50 to 2.34). After simultaneous adjustment for other antigens, positive associations remained significant for NCGC (CagA, HP1564, HP0305) and CGC (CagA, HP1564, HyuA). Compared with CagA sero-positive only individuals, those who were positive for all three antigens had an adjusted HR of 5.59 (95% CI 4.68–6.66) for NCGC and 2.17 (95% CI 1.54–3.05) for CGC. In the meta-analysis of NCGC, the pooled relative risk for CagA was 2.96 (95% CI 2.58–3.41) [Europeans: 5.32 (95% CI 4.05–6.99); Asians: 2.41 (95% CI 2.05–2.83); P heterogeneity <0.0001]. Similar pronounced population differences were also evident for GroEL, HP1564, HcpC and HP0305. In meta-analyses of CGC, two antigens (CagA, HP1564) were significantly associated with a higher risk in Asians but not Europeans. Conclusions Sero-positivity to several H. pylori antigens was significantly associated with an increased risk of NCGC and CGC, with varying effects between Asian and European populations.

CITATION EXPORT

Pang Yao, Christiana Kartsonaki, Julia Butt et al.. Helicobacter pylori multiplex serology and risk of non-cardia and cardia gastric cancer: a case-cohort study and meta-analysis. International Journal of Epidemiology. (2023). https://doi.org/10.1093/ije/dyad007

AUTHORS

21 · 32 CENTRES

Pang Yao, Christiana Kartsonaki, Julia Butt, Rima Jeske, Catherine de Martel, Martyn Plummer, Yu Guo, Sarah Clark, Robin G Walters, Yiping Chen, Daniel Avery, Jun Lv, Canqing Yu, Hao Wang, Michael Hill, Richard Peto, Liming Li, Tim Waterboer, Zhengming Chen, Iona Y Millwood, Ling Yang

Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Infections and Cancer Epidemiology Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
Infections and Cancer Epidemiology Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer, Lyon, France
Department of Statistics, University of Warwick, Coventry, UK
National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
NCDs Prevention and Control Department, Zhejiang CDC, Zhejiang, China
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
Center for Public Health and Epidemic Preparedness & Response, Peking University, Beijing, China
Infections and Cancer Epidemiology Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Oxford, UK