High-negative anti-Helicobacter pylori IgG antibody titers and long-term risk of gastric cancer: Results from a large-scale population-based cohort study in Japan
Menée au Japon sur la période 1993-2013 auprès de 19 106 personnes (âge moyen : 56,7 ans ; durée moyenne de suivi : 18 ans ; 64% de femmes), cette étude analyse l'association entre les niveaux sériques des anticorps anti-Helicobacter pylori et des pepsinogènes I ou II, et le risque à long terme de cancer de l'estomac (595 cas)
Résumé en anglais
Background : Serological testing of anti-Helicobacter pylori (Hp) antibody, together with testing of pepsinogen I and II, is now widely used to stratify groups at high risk of gastric cancer in Japan. Those with a negative anti-Hp IgG titer, especially "high-negative" (3-<10U/mL), are speculated to have higher risk of gastric cancer. We aimed to evaluate the association between a high-negative anti-Hp IgG titer and the long-term risk of gastric cancer in the Japan Public Health Center-based Prospective Study (JPHC Study) Cohort II.
Methods : The study population consisted of 19,106 Japanese men and women who were followed from 1993-2013. A Cox proportional hazards model was used to assess the risk of gastric cancer for plasma anti-Hp IgG titers, together with the severity of atrophic gastritis (AG) by pepsinogen I and II levels. A total of 595 cases of gastric cancer occurred during an average of 18 years of follow-up.
Results : Compared to those with a low-negative anti-Hp IgG titer (≤3U/mL), subjects with a high-negative titer (3-<10U/mL) showed a significantly elevated risk of gastric cancer (HR=2.81, CI=1.62-4.89). Among those with a high-negative titer, risk increase was observed under moderate or severe AG (HR=18.73, CI=8.83-39.70).
Conclusion : Our results suggest that those with a high-negative anti-Hp IgG titer and moderate and severe AG are at increased long-term risk of gastric cancer.
Impact : Development of moderate or severe AG in subjects with high-negative anti-Hp IgG titer is suggested to increase risk of gastric cancer.
