Sodium intake, salt taste and gastric cancer risk according to helicobacter pylori infection, smoking, histological type and tumor site in china

Aim: The risk factors mostly strongly associated with gastric cancer are gastric bacteria Helicobacter pyloriand diet. Using a case-control study among residents in Jinan, we examined the association between the salt tasteand gastric cancer according to H. pylori infection, smoking and histological type as well as tumor site. Methods:This population-based case-control study included 207 cases and 410 controls. Data on potential risk factors ofgastric cancer were obtained by interview of cases and controls with a questionnaire, salt taste preference wasmeasured for all subjects, and IgG antibodies to H. pylori were applied to assess infection. Risk measures weredetermined using unconditional logistic regression. Results: The proportions of salt taste at intervals of 1.8-7.2g/L and ≥7.2 g/L were significantly higher in cases than controls, with ORs of 1.56 (1.23-3.64) and 2.03 (2.12-4.11), respectively, subjects with high salt intake having an elevated risk for gastric cancer when infected withH. pylori. Significant modification by smoking and tumor site was observed across the different measures of saltintake, the highest salt taste showed higher cancer risk in ever smokers or with non-cardia cancers. Conclusion:Our study supports the view that high intake of sodium is an important dietary risk factor for gastric cancer,with a synergistic effect found between salt and H.pylori and smoking, dependent on the tumor site.     

Gastric Cancer: the Roles of Diet,Alcohol Drinking,Smoking and Helicobacter pylori in Northeastern Thailand

The incidence of gastric cancer in the countries of South East Asia is variable, ranging from age-standardized ‍rates of 20.9/105 (men) and 10.4/105 (women) in Hanoi, Vietnam to 4.1/105 (men) and 2.1/105 (women) in Khon Kaen, ‍Thailand. The reasons for these differences are unknown. Possible explanations are differences in dietary habits, ‍alcohol drinking, smoking and/or the prevalence of infection with Helicobacter pylori (H. pylori). A case-control ‍study was conducted in Khon Kaen, Thailand, to study the role of these factors in gastric cancer carcinogenesis. 131 ‍gastric cancer cases and 262 matched controls were recruited for the study. Information on dietary habits, alcohol ‍drinking and smoking were collected by a structured questionnaire. Blood samples were available from 111 cases ‍and 232 controls for H. pylori assay. Using an unconditional logistic regression model controlling for age and sex, we ‍assessed the effects of dietary habits, alcohol drinking, smoking and H. pylori infection on the risk of gastric cancer. ‍A high intake of salt (OR=1.8; 95%CI 1.1-3.0) and fermented foods (OR=1.9; 95%CI 1.1-3.3) was found to be ‍associated with an increased risk. Preference for spicy food was not associated with gastric cancer risk in this ‍population. Although there were negative associations between gastric cancer and vegetable and fruit intake, they ‍were rather weak (OR 0.8 for both) and non significant. There were also weak (non-significant) associations with ‍smoking and alcohol consumption, and no association with H. pylori infection (OR=0.6; 95%CI 0.4-1.0). Infection of ‍H. pylori was associated with various indicators of crowding. ‍     

Determining Gastric Cancer-Related Risk Factors in Mongolian Population Using ABC(D) Method: A Matched Case-Control Study

Objective: We aimed to identify gastric cancer-related risk factors and evaluate the efficacy of screening ABC(D) method in determining high risk  gastric cancer individuals in Mongolian population. Methods: A total of 240 participants (120 gastric cancer patients and 120 healthy individuals) were included in this study. Data were collecting using a structured questionnaire consisting of 56 questions covering 5 categories. Serum Helicobacter pylori IgG (H. pylori IgG), pepsinogen I (PGI), and pepsinogen II (PGII) were tested in one third of all the participants (40 gastric cancer patients and 40 controls).  PGI, PGII, and H. pylori IgG levels were measured using GastroPanel enzyme-linked immunosorbent assay kit (Biohit, Helsinki, Finland). Results: Habits of having leftover meals (OR 2.22, 95%CI 1.27-3.86, p<0.01), daily consumption of tea with salt (OR 1.97, 95%CI 1.18-3.30, p<0.01), smoking on an empty stomach (OR 2.44, 95%CI 1.11-5.37, p<0.05), daily consumption of vegetables (OR 0.45, 95%CI 0.27-0.76, p<0.01), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p<0.05), family history of gastric cancer (parents OR 2.88, 95%CI 1.07-7.78, p<0.05, siblings (OR 3.09, 95%CI 1.09-8.81, p<0.05), and history of gastric diseases (OR 3.65, 95%CI 2.10-6.35, p<0.0001) were identified as protective factors. A low PGI level (<35.25ng/ml) and low PGI/II ratio (<4) were associated with gastric cancer risk. According to ABC(D) method, groups C and D had higher proportion of gastric cancer cases than group A and B (group C, OR 7.50, 95%CI 1.20-47.05, p<0.05; group D, OR 8.3, 95%CI 1.33-51.26, p<0.05). Conclusion: Our findings suggested that gastric cancer risk was more closely related to eating habits, smoking, family history, and precancerous lesions. ABC(D) method seems to be a plausible alternative or supplementary method for stratifying patients at high risk of gastric cancer in this country.     

SNPs of Excision Repair Cross Complementing Group 5 and Gastric Cancer Risk in Chinese Populations

We conducted a case-control study to determine the association between several potential SNPs of excisionrepair cross complementing group 5 (XPG) and gastric cancer susceptibility, and roles of XPG polymorphismsin combination with H.pylori infection in determining risk of gastric cancer. In our study, we collected 337 newlydiagnosed gastric cancer cases and 347 health controls. Three SNPs of XPG, rs2296147T>C, rs2094258C>Tand rs873601G>A, were genotyped using the Taqman real-time PCR method with a 7900 HT sequence detectorsystem. H. pylori infection was diagnosed by ELISA. By multivariate logistic regression analysis, the rs2296147CC genotype was associated with a decreased risk of gastric cancer (OR=0.52, 95% CI=0.27-0.97), and rs2094258TT was associated with elevated risk (OR=2.13, 95% CI=1.22-3.35). Positive H.pylori individuals with rs2094258TT genotypes demonstrated increased risk of gastric cancer (OR=2.13, 95% CI=1.22-3.35), while rs2296147 CCwas associated with lower risk among patients with negative H.pylori (OR=0.45, 95%CI=0.22-0.89). Our findingssuggested that XPG polymorphisms might contribute to risk of gastric cancer among Chinese populations, butthe effect needs to be further validated by larger sample size studies.     

Salt intake and gastric cancer risk according to Helicobacter pylori infection, smoking, tumour site and histological type

Background:

Although salt intake is considered a probable risk factor for gastric cancer, relevant studies have provided heterogeneous results, and the magnitude of the association has not been accurately quantified.

Methods:

To quantify gastric cancer risk in relation to dietary salt exposure according to Helicobacter pylori infection status and virulence, smoking, tumour site, and histological type, we evaluated 422 gastric cancer cases and 649 community controls. Salt exposure was estimated in the year before the onset of symptoms through: sodium intake (estimated by a food frequency questionnaire (FFQ)); main food items/groups contributing to dietary sodium intake; visual analogical scale for salt intake preference; use of table salt; and duration of refrigerator ownership.

Results:

Comparing subjects with the highest with those with the lowest salt exposure (3rd vs 1st third), sodium intake (OR=2.01, 95% CI: 1.16–3.46), consumption of food items with high contribution to sodium intake (OR=2.54, 95% CI: 1.56–4.14) and salt intake evaluated by visual analogical scale (OR=1.83, 95% CI: 1.28–2.63) were associated with an increased gastric cancer risk. Subjects owning a refrigerator for >50 years had a lower risk for gastric cancer (OR=0.28, 95% CI: 0.14–0.57). These associations were observed regardless of H. pylori infection status and virulence, smoking, tumour site or histological type.

Conclusion:

Our results support the view that salt intake is an important dietary risk factor for gastric cancer, and confirms the evidence of no differences in risk according to H. pylori infection and virulence, smoking, tumour site and histological type.     

Salt Taste Sensitivity,Physical Activity and Gastric Cancer

Background: Gastric cancer is one of the main health issues in China. The risk factors of the disease arerelated to nutrition and environment. Salt taste sensitivity is the capacity to identify the flavor of salt. Salttaste sensitivity threshold (STST) can influence salt appetite, and it is assumed to have association with gastriccancer. Methods: A 1:2 matched hospital based case-control study including 300 cases with newly histologicalconfirmed diagnosis of gastric cancer and 600 controls that were cancer and gastric diseases free were used. Aself-designed questionnaire was used to collect information dietary and lifestyle habit, and physical activity, andsalt taste sensitivity test was used to measure the STST for all subjects. Conditional logistic regression was usedto calculated Odds Ratios (ORs) and 95% confidence intervals (95% CI). Results: An increased risk of gastriccancer is related to the consumption of smoking, drinking, family history of cancer and salted food. Walkingand sports activity [adjust OR=0.69(0.51-0.99) for ≥4 times/week] presented protective effect for gastric cancer.There is a significant positive association between increased STST and gastric cancer, and the adjusted OR was2.05(1.68-2.5). When we used STST≥5 as a cut point, people with STST≥5 were at 5.71 times greater risk ofgastric cancer than those with STST<5. STST showed moderate association with physical activity (Correlationcoefficient =0.22). Cut point of STST ≥5 had a best sensitivity and specificity for predicting gastric cancer riskdetection (sensitivity for 73.67%, specificity for 57%). Conclusion:Salt and salted food intake is association withgastric cancer, while physical activity showed protective effect. A high STST is strong association with gastriccancer risk.     

Peroxisome Proliferator-Activated Receptor-Gamma Pro12Ala Polymorphism Could be a Risk Factor for Gastric Cancer

Background: Due to the strong inhibitory effects of PPARγ gene on the growth of cancer cells, the role ofPro12Ala polymorphism in PPARγ gene has been extensively investigated in cancer recently. However, theresults were inconsistent according to cancer type. The aim of this study was to comprehensively evaluate thePPARγ Pro12Ala polymorphism and gastric cancer susceptibility. Materials and Methods: Search strategieswere conducted in Pubmed, Medline (Ovid), Chinese biomedical database (CBM), China national knowledgeinfrastructure (CNKI), VIP, and Wanfang database, covering all publications, with the last search up to November01, 2014. The strength of association between PPARγ Pro12Ala polymorphism and gastric cancer risk was assessedby OR with 95%CI. Results: A total of 546 cases and 827 controls in 5 case-control studies were included in thismeta-analysis. The results indicated that the variant G allele carriers (CG+GG) had a 2.31 times higher risk forgastric cancer when compared with the homozygote CC (odds ratio (OR)=2.31, 95% confidence interval (CI)=1.67-3.21 for CG+GG vs. CC). In the subgroup analysis by ethnicity, significantly elevated risks were both found inAsians (OR=2.56, 95% CI=1.42-4.64) and Caucasians (OR=2.20, 95% CI=1.48-3.25). Similarly, in the subgroupanalysis by H. pylori status, a significantly increased risk was identified in H. pylori (+) populations (OR=3.68,95%CI=2.07-6.52), but not in H. pylori(-) populations (OR=1.17, 95%CI=0.58-2.39). Conclusions: This pooledanalysis suggested that the PPARγ Pro12Ala polymorphism could be an independent predictive risk factor forgastric cancer especially in H. pylori infected populations in Asians and Caucasians. Nevertheless, prospectivelydesigned cohort studies are needed to further investigate gene-gene and gene-environment interactions to confirmthe combined effects of PPARγ Pro12Ala polymorphisms and H. pylori infection on gastric cancer risk.     

Fruit and Vegetable Intake and Stomach Cancer among Male Adults: A Case-Control Study in Northern Viet Nam

Objective: This study investigated the association between fruit and vegetable intake and stomach cancer, with considering the impacts of Helicobacter pylori (H. pylori) infection and tobacco smoking. Methods: A case-control study featuring 80 male incident stomach-cancer cases and 126 male controls was conducted in a general hospital in Viet Nam. A semi-quantitative food frequency and demographic lifestyle questionnaire were used; and venous blood samples were collected to determine H. pylori status by IgG ELISA. The respective associations between fruit and vegetable intake and stomach cancer were examined using unconditional logistic regression analysis with adjustments for possible cofactors. Results: Fruit intake and stomach cancer showed a weak inverse association when this became non-significant after adjusting for H. pylori infection (OR = 0.50, 95%CI: 0.22–1.12, p trend = 0.094). Stratifying by H. pylori status returned a negative trend for fruit intake and stomach cancer among H. pylori-negative participants (OR = 0.21, 95%CI: 0.06–0.69, p trend = 0.010), but no significant interaction for H. pylori-positive participants (OR = 0.76, 95%CI: 0.21–2.68, p trend = 0.670). Vegetable intake and stomach cancer showed no association, regardless of H. pylori status. Compared to ever-smokers with low intake, never-smokers with high vegetable (OR = 0.25, 95% CI: 0.06–0.95) and fruit intake (OR = 0.20, 95%CI: 0.06–0.65) showed the lowest odds of stomach cancer. Conclusions: Fruit, but not vegetable, intake showed a weak inverse association with stomach cancer. H. pylori infection and tobacco-smoking status may influence the protective effects of fruit and vegetable intake on stomach cancer.     

Seroreactivity to Helicobacter pylori Antigens as a Risk Indicatorof Gastric Cancer

Background: Multiple etiologic factors are suspected to cause gastric cancer, the most important of whichis infection with virulent types of Helicobacter pylori. Materials and Methods: We have compared 102 gastriccancer patients with 122 non-ulcer, non-cancer dyspeptic patients. Gastric specimens were evaluated for H.pylori infection by tissue-based detection methods. Patient sera underwent antigen-specific ELISA and westernblotting using a Helicoblot 2.1 kit and antibody responses to various H. pylori antigens were assessed. Results:The absolute majority (97-100%) of both groups were H. pylori seropositive. Multivariate regression analysisdemonstrated serum antibodies to the low molecular weight 35kDa protein to be protective and reduce the riskof gastric cancer by 60% (OR:0.4; 95%CI:0.1-0.9). Conversely, seroreactivity to the 89kDa (VacA) protein wassignificantly higher in gastric cancer patients (OR:2.7; 95%CI:1.0-7.1). There was a highly significant association(p<0.001) between seroreactivity to the 116kDa (CagA) and 89kDa (VacA) proteins, and double positive subjectswere found at nearly five fold (OR:4.9; 95%CI:1.0-24.4) enhanced risk of gastric cancer as compared to doublenegative subjects. Conclusions: Seroreactivity to H. pylori low (35kDa) and high (116kDa/89kDa) molecularweight antigens were respectively revealed as protective and risk indicators for gastric cancer.     

Diet and Cancer Risk in the Korean Population: A Metaanalysis

Many studies have found links between diet and cancer. The summary estimates of the association betweendietary factors and cancer risk were investigated using previously reported studies of the Korean population.Gastric cancer risk was inversely associated with the high intake of soy foods [OR (95% CI): 0.32 (0.25-0.40)for soybean, 0.56 (0.45-0.71) for soybean curd, and 0.67 (0.46-0.98) for soymilk], allium vegetables [OR (95%CI): 0.37 (0.26-0.53) for green onion, 0.54 (0.40-0.73) for garlic, and 0.54 (0.35-0.85) for onion], fruits [OR (95%CI): 0.61 (0.42-0.88)], and mushrooms [OR (95% CI): 0.43 (0.21-0.88)]. Salt and Kimchi were associated with anincreased gastric cancer risk [OR (95% CI): 1.92 (1.52-2.43) and 2.21 (1.29-3.77), respectively]. Colorectal cancerrisk was positively associated with meat intake [OR (95% CI): 1.25 (1.15-1.36)]. Total soy products, soybeancurd, and soymilk showed an inverse association with breast cancer risk [OR (95% CI): 0.61 (0.38-0.99), 0.47(0.34-0.66), and 0.75 (0.57-0.98), respectively]. Green/yellow and light colored vegetables were associated witha reduced risk of breast cancer [OR (95% CI): 0.34 (0.23-0.49) and 0.44 (0.21-0.90), respectively]. Mushroomintake was inversely associated in pre-menopausal women only [OR (95% CI): 0.47 (0.26-0.86)]. In conclusion,soy foods, fruits and vegetables might reduce cancer risk in the Korean population. High salt food might be riskfactor for gastric cancer, and intake of high amount of meat might cause colorectal cancer.     

The 765G>C Polymorphism in the Cyclooxygenase-2 Gene and Gastric Cancer Risk: an Update by Meta-analysis

Background: The 765G>C polymorphism in cyclooxygenase-2 (COX-2) gene has been extensively investigatedfor association with gastric cancer (GC). However, the results of different studies have been inconsistent. The aimof this study is to comprehensively evaluate the genetic risk of -765G>C polymorphism in the COX-2 gene forGC. Materials and Methods: We searched Pubmed, Embase, Medline, CNKI database, Wanfang database, Weipudatabase, and Chinese Biomedical database, covering all publications (last search been performed on Jan 10,2014). Statistical analyses were performed using Revman 5.2 and STATA 10.0 software. Results: A total of 1,874cases and 3,005 controls in 10 case-control studies were included in this meta-analysis. The results indicated thatthe variant C allele carriers (GC+CC) had a 69% increased risk of GC when compared with the homozygote GG(odds ratio (OR)=1.69, 95% confidence interval (CI), 1.10-2.61 for GC+CC vs GG). In the subgroup analysis byethnicity, significant elevated risks were associated with C allele carriers in Asians (OR=1.75, 95%CI=1.40-2.18,and p<0.00001) and in Indians (OR=8.38, 95%CI=4.34-16.16, and p<0.00001) but not in Caucasians (OR=1.07,95%CI=0.81-1.42, and p=0.62) or in Dutch (OR=0.53, 95%CI= 0.33-0.87, and p= 0.01).In the subgroup analysisby Helicobacter pylori (H. pylori) status, a significantly increased risk was identified among H. pylori (+) (OR=3.58,95%CI=2.33-3.50, and p<0.00001) and H. pylori (-) (OR=2.32, 95%CI=1.46-3.69, and p=0.0004). Conclusions:This meta-analysis suggested that the -765G>C polymorphism in the COX-2 gene could be a risk factor for GCin Asians and Indians.     

Promoter methylation of p16 associated with Helicobacter pylori infection in precancerous gastric lesions: a population-based study

To investigate the relationship between p16 methylation and Helicobacter pylori infection in precancerous gastric lesions, a population-based study was conducted in Linqu County, a high-risk area of gastric cancer in China. Methylation status of p16 was evaluated by methylation-specific polymerase chain reaction in 920 subjects with precancerous gastric lesions. H. pylori status was determined by 13C-urea breath test and the density of H. pylori in biopsy specimens used for detecting methylation status was assessed by the modified Giemsa stain. The frequency of p16 methylation was significantly higher in subjects with H. pylori positive than those with H. pylori negative in each category of gastric lesion (p<0.001, respectively). Compared with H. pylori negative, the odds ratios (ORs) of p16 methylation were markedly elevated in subjects with H. pylori positive for superficial gastritis (OR, 9.45; 95% confidence interval [CI]: 2.94-30.41), chronic atrophic gastritis (OR, 15.92; 95%CI: 7.60-33.36), intestinal metaplasia (OR, 4.46; 95%CI: 2.44-8.13), indefinite dysplasia (OR, 3.67; 95%CI: 1.90-7.10), and dysplasia (OR, 2.48; 95%CI: 1.02-5.99). Moreover, the frequencies of p16 methylation increased steadily with the severity of H. pylori density in gastric mucosa. Compared with H. pylori negative, the OR of p16 methylation was 1.02-16.13 times higher in subjects with mild H. pylori infection, and 2.69-38.73 times higher in those with moderate/severe infection, respectively. Our findings indicate that p16 methylation was significantly associated with H. pylori infection in precancerous gastric lesions, suggesting that H. pylori infection could potently induce methylation of p16 CpG island.     

Trans-Lycopene and β-Cryptoxanthin Intake and Stomach Cancer in Vietnamese Men: A Pilot Case-Control Study

Objective: To examine the association between dietary intake of Trans-Lycopene and β-Cryptoxanthin and stomach cancer in Vietnamese men. Methods: A case-control study including 80 male incident stomach cancer cases and 146 male controls was performed in a general hospital in Viet Nam. A validated semi-quantitative food frequency (SQFFQ) and demographic lifestyle questionnaire were designed, and venous blood samples were collected to determine H. pylori status by IgG ELISA. Nutrient intake was converted using the data of SQFFQ and the Nutritive Composition Table of Vietnamese Foods, updated in 2019. The respective associations between Trans-Lycopene and β-Cryptoxanthin intake and stomach cancer were examined using unconditional logistic regression analysis with adjustments for possible cofactors. Results: Both Trans-Lycopene and β-Cryptoxanthin intake and stomach cancer showed a significantly inverse association, tertile-3 versus tertile-1, (OR = 0.15, 95%CI: 0.06–0.35, p trend = 0.00) and (OR = 0.34, 95%CI: 0.14–0.79, p trend = 0.02, respectively). For Trans-Lycopene intake stratifying by H. pylori status remained the benefit effect against stomach cancer among H. pylori-negative participants (OR = 0.15, 95%CI: 0.03–0.69, p trend = 0.02) and H. pylori-positive participants (OR = 0.13, 95%CI: 0.04–0.42, p trend = 0.00). Conclusions: Both Trans-Lycopene and β-Cryptoxanthin intake showed a strong protective effect against stomach cancer. The findings suggest that these two types of fat-soluble micronutrients would be considered as an anti-cancer therapy for both primary and secondary prevention.     

Helicobacter pylori strain types and risk of gastric cancer: a case-control study.

The aim of this novel endoscopy clinic-based case-control study was to explore the influence of different Helicobacter pylori strain types on the risk of gastric adenocarcinoma using isolated bacterial strains, tissue samples, and sera. We included 72 cases with gastric adenocarcinoma and 324 age- and sex-matched controls. Histological characterization, culture, molecular typing of H. pylori genes by PCR (cagA/vacA), conventional IgG ELISA, and immunoblotting (Western blot) for the CagA and VacA proteins were performed. With four tests combined, H. pylori infection was detected in 57 (79%) cases and 213 (66%) controls. A positive association between H. pylori infection and gastric cancer risk was found [odds ratio (OR), 2.1; 95% confidence interval, 1.1-3.9]. Type I (OR, 1.8), intermediate (OR, 2.0), and type H (OR, 0.2) strains of H. pylori presented different serum antibody levels and different levels of association with gastric cancer. Our case-control study, based on molecular characterization and serology, provides further evidence that infection by more virulent strains of H. pylori and the presence of antibodies toward the CagA protein can be used as markers for an increased risk of gastric adenocarcinoma and that the strain types of H. pylori could be used in the future to determine disease outcome.     

Clinical Characteristics and Helicobacter pylori Status of Gastric Cancer in Thailand

Background: Gastric cancer is the second leading course of cancer death worldwide and H. pylori infectionis an important risk factor for gastric cancer development. This study was design to evaluate the clinical,pathological features, survival rate and prevalence of H. pylori infection in gastric cancer in Thailand. Materialsand Methods: Clinical information, histological features, endoscopic findings and H. pylori status were collectedfrom gastric cancer patients from Thammasat university hospital during June 1996-December 2011. H. pyloriinfection was assessed by histological evaluation, rapid urease test and serological test. Clinical information,endoscopic findings and histopathology of all patients were recorded and compared between patients with activeor non-active H. pylori infection. Results: A total of 100 gastric cancer patients (55 men and 45 women withmean age of 55±16.8 years) were enrolled in this study. Common presenting symptoms were dyspepsia (74%),weight loss (66%), anemia (63%) and anorexia (38%). Mean duration of symptoms prior to diagnosis was 98days. Overall prevalence of H. pylori infection was 83% and active H. pylori infection was 40%. 1-year and5-year survival rates were 43% and 0%. There was no significant difference between active H. pylori infectionin different locations (proximal vs non-proximal: 47.1% vs 48.5%; P-value = 0.9, OR=0.9; 95%CI =0.3-3.1) andhistology of gastric cancer (diffuse type vs intestinal type: 47.4% vs 50%; P-value= 0.8, OR=0.9, 95%CI=0.3-2.7).However, linitis plastica was significantly more common in non-active than active H. pylori infection (27.9% vs0%; P-value <0.0001, OR =13.3, 95%CI=3.2-64.5). Moreover, gastric cancer stage 4 was higher in non-active thanactive H. pylori infection (93% vs 50%, P-value<0.001). Conclusions: Prevalence of H. pylori infection in Thaigastric cancer patients was high but active infection was low. Most gastric cancer patients presented in advancestage and had a grave prognosis. Screening for gastric cancer in high risk individuals might be an appropriatetool for early detection and improve the treatment outcome for this particular disease in Thailand.     

Helicobacter pylori Infection Impacts on Functional Dyspepsia in Thailand

Background: Helicobacter pylori (H. pylori) is a well known major cause of gastric cancer and even whenasymptomatic infected patients are at elevated risk. Functional dyspepsia (FD) is also one of the most commongastrointestinal diseases, which greatly impacts the quality of life. H. pylori infection and psychosocial stress arefrequently associated with FD but limited studies have confirmed the relationships, especially in Southeast Asiancountries. Here we aimed to investigate the prevalence and impact of H. pylori infection, anxiety and depressionon Thai FD patients. Materials and Methods: This cross-sectional study was conducted in a tertiary care centerin Thailand, during February 2013-January 2014. All FD patients were diagnosed and categorized by Rome IIIcriteria into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) groups. The HospitalAnxiety and Depression Scale was used to evaluate psychological status. The presence of H. pylori was definedas positive with H. pylori culture, positive rapid urease test or positive histology. Results: Three hundred FDpatients were included, 174 (58%) female. Overall mean age was 54.8+15.1 years. There were 192 (64%) patientswith PDS and 108 (36%) with EPS. H. pylori infection was demonstrated in 70 (23.3%) patients. Anxiety anddepression were documented in 69 (23%) and 22 (7.3%), respectively. H. pylori infection, anxiety and depressionwere significantly higher in PDS than EPS patients (27.1% vs 16.7%; p=0.04; OR=1.86; 95%CI=1.01-3.53 and29.7% vs 11.1%; p=0.0002; OR=3.4; 95%CI=1.7-7.1 and 10.4% vs 1.9%; p=0.006; OR=6.2; 95%CI=1.4-38.9,respectively). Conclusions: H. pylori infection, anxiety and depression were commonly found in Thai FD patientsand more prevalent in PDS than EPS. H. pylori eradication might be the key to success for the treatment of ThaiFD patients and prevent the development of gastric cancer.     

The NAD(P)H: Quinine Oxidoreductase 1 (NQO1) Gene 609 C>T Polymorphism is Associated with Gastric Cancer Risk: Evidence from a Case-control Study and a Meta-analysis

The association between the NAD(P)H:quinone oxidoreductase 1 (NQO1) gene C609T polymorphism(rs1800566) and gastric cancer has been widely evaluated, but a definitive answer is so far lacking. We firstconducted a case-control study to assess this association in a large Han Chinese population, and then performeda meta-analysis to further address this issue. Although our case-control association study indicated no significantdifference in the genotype and allele distributions of C609T polymorphism between gastric cancer patientsand controls, in the meta analysis involving 4,000 subjects, comparison of alleles 609T and 609C indicated asignificantly increased risk (46%) for gastric cancer (95% confidence interval (95%CI) for odds ratio (OR)=1.20-1.79) in individuals with the T allele. The tendency was similar to the homozygote (OR=1.81, 95%CI: 1.16-2.84),dominant models (OR=1.41, 95%CI: 1.12-1.79), as well as recessive model (OR=1.58, 95%CI: 1.06-2.35). Stratifiedanalysis by study design demonstrated stronger associations in population-based than in hospital-based studies.And ethnicity-based analysis demonstrated a significant association in Asians. We conclude that the NQO1 geneC609T polymorphism increases the risk for gastric cancer, especially in Asian populations.     

Risk for gastric cancer after antibiotic prophylaxis in patients undergoing hip replacement

Despite strong evidence of an association between Helicobacter pylori and gastric cancer, the benefit of eradicating H. pylori infection is unknown. Our aim was to test the hypothesis that exposure to high doses of antibiotics reduces risk for gastric cancer via possible eradication of H. pylori We conducted a nationwide case-control study nested in a cohort of 39,154 patients who underwent hip replacement surgery between 1965 and 1983. Such patients frequently receive prophylactic antibiotic treatment. During follow-up through 1989, we identified 189 incident cases of gastric cancer. For each case, three controls were selected from the cohort. Exposure data were abstracted from hospital records. Blood samples from a separate cohort undergoing hip replacement surgery were analyzed for anti-H. pylori IgG before and after surgery. Both long-term antibiotic treatment before surgery [odds ratio (OR), 0.3; 95% confidence interval (CI), 0.1-0.7] and prophylactic antibiotic treatment (OR, 0.7; 95% CI, 0.5-1.1) conferred a reduction in gastric cancer risk. The reduction appeared stronger after 5 years (OR, 0.6; 95% CI, 0.3-1.2) than during shorter follow-up after hip replacement (OR, 0.8; 95% CI, 0.4-1.7). There was an apparent decrease in risk with increasing body weight-adjusted doses of antibiotics (P = 0.13). However, the rate of H. pylori antibody disappearance was not strikingly higher in the cohort of patients undergoing hip replacement than in a control cohort. Our findings provide indirect support for the hypothesis that treatment with antibiotics at a relatively advanced age reduces the risk of gastric cancer.     

Neglected role of hookah and opium in gastric carcinogenesis: A cohort study on risk factors and attributable fractions

A recent study showed an association between hookah/opium use and gastric cancer but no study has investigated the relationship with gastric precancerous lesions. We examined the association between hookah/opium and gastric precancerous lesions and subsequent gastric cancer. In a population‐based cohort study, 928 randomly selected, healthy, Helicobacter pylori‐infected subjects in Ardabil Province, Iran, were followed for 10 years. The association between baseline precancerous lesions and lifestyle risk factors (including hookah/opium) was analyzed using logistic regression and presented as odds ratios (ORs) and 95% confidence intervals (CIs). We also calculated hazard ratios (HRs) and 95% CIs for the associations of lifestyle risk factors and endoscopic and histological parameters with incident gastric cancers using Cox regression models. Additionally, the proportion of cancers attributable to modifiable risk factors was calculated. During 9,096 person‐years of follow‐up, 36 new cases of gastric cancer were observed (incidence rate: 3.96/1,000 persons‐years). Opium consumption was strongly associated with baseline antral (OR: 3.2; 95% CI: 1.2–9.1) and body intestinal metaplasia (OR: 7.3; 95% CI: 2.5–21.5). Opium (HR: 3.2; 95% CI: 1.4–7.7), hookah (HR: 3.4; 95% CI: 1.7–7.1) and cigarette use (HR: 3.2; 95% CI: 1.4–7.5), as well as high salt intake, family history of gastric cancer, gastric ulcer and histological atrophic gastritis and intestinal metaplasia of body were associated with higher risk of gastric cancer. The fraction of cancers attributable jointly to high salt, low fruit intake, smoking (including hookah) and opium was 93% (95% CI: 83–98). Hookah and opium use are risk factors for gastric cancer as well as for precancerous lesions. Hookah, opium, cigarette and high salt intake are important modifiable risk factors in this high‐incidence gastric cancer area.     

P53 Codon 72 polymorphisms: a case-control study of gastric cancer and potential interactions

P53 codon 72 polymorphisms have been reported to be associated with cancers of the lung, esophagus and cervix. However, there have been no reports on the interaction of select risk factors and p53 codon 72 polymorphisms in gastric cancer susceptibility. 155 gastric cancer cases and 134 cancer-free controls were enrolled at the Memorial Sloan Kettering Cancer Center (MSKCC) from November 1992 to November 1994. The crude odds ratio (OR1) associated with the (Pro/Pro) polymorphism and the risk of gastric cancer was 1.27 (0.70-2.33). Adjusting for age, sex, race and education (OR2) and further adjusting for BMI, calories, sodium, smoking, vitamin C, fiber, alcohol, fat, and H. pylori status (OR3) did not yield significant results. Significant joint effects were associated with high fat consumption (OR1=2.61 (95% CI:1.13-6.06); OR2=2.85 (95% CI:1.14-7.15) for total cancers and for proximal tumors (OR1=2.56 (95%CI:1.00-6.54)). The low vitamin C intake/high-risk polymorphism group (Pro/Pro) had an OR1 of 4.82 (95% CI: 1.72-13.45) and the OR2 was 6.19 (95% CI: 2.08-18.40) for distal tumors. The point estimates were increased for interaction odds ratios but not statistically significant (OR1=4.25 (95% CI: 0.66-27.50); OR2=4.73 (95% CI: 0.67-33.43); OR3=5.55 (95% CI: 0.66-46.47)). Further studies specifically looking at proximal and distal tumors are required to confirm any potential interaction between the p53 codon 72 polymorphisms and environmental risk, in particular low dietary vitamin C and high fat consumption.