Association Between Infections With CagA-positive or -Negative Strains of Helicobacter Pylori and Risk for Gastric Cancer in Young Adults. Research Group on Prevention of Gastric Carcinoma Among Young Adults

Am J Gastroenterol. 1999 Dec;94(12):3455-9. doi: 10.1111/j.1572-0241.1999.01607.x.


Objective: We assessed the association between infection with CagA-positive and -negative Helicobacter pylori and the risk of gastric cancer in young adults.

Methods: CagA IgG antibodies were measured in sera of subjects participating in a case-control study in Japan. The study subjects were 103 gastric cancer patients <40 yr of age, 100 inpatients with benign diseases, and 101 screenees younger than age 43 yr.

Results: Compared with the H. pylori-negative/CagA-negative (H. pylori-/CagA-) group, both the H. pylori-positive/CagA-negative (H. pylori+/CagA-) group and the H. pylori-positive/CagA-positive (H. pylori+/CagA+) groups showed elevated odds ratios for intestinal-type, diffuse-type, early, advanced, proximal, and distal gastric cancers. All the relationships were significant except for the H. pylori+/CagA- group in relation to proximal cancer. The overall odds ratios (95% confidence intervals) for gastric cancer in the H. pylori+/CagA- and the H. pylori+/CagA+ groups were 15.0 (6.4, 35.2) and 14.6 (6.7, 31.9), respectively. Between these two groups, no significant difference was observed in risks for intestinal-type, diffuse-type, early, advanced, proximal, or distal gastric cancer.

Conclusions: In those <40 yr of age, it is concluded that both CagA-positive and CagA-negative H. pylori infections are related to risks of intestinal-type, diffuse-type, early, advanced, and distal gastric cancers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Bacterial / blood
  • Antigens, Bacterial*
  • Bacterial Proteins / genetics*
  • Bacterial Proteins / immunology
  • Case-Control Studies
  • Female
  • Gene Expression Regulation, Bacterial / physiology
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / immunology
  • Helicobacter Infections / microbiology*
  • Helicobacter pylori / genetics*
  • Helicobacter pylori / immunology
  • Helicobacter pylori / pathogenicity
  • Humans
  • Japan
  • Male
  • Risk Factors
  • Seroepidemiologic Studies
  • Stomach Neoplasms / diagnosis
  • Stomach Neoplasms / immunology
  • Stomach Neoplasms / microbiology*
  • Virulence / genetics


  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Bacterial Proteins
  • cagA protein, Helicobacter pylori