Assessment of gastric carcinoma risk associated with Helicobacter pylori may vary depending on the antigen used: CagA specific enzyme-linked immunoadsorbent assay (ELISA) versus commercially available H. pylori ELISAs

Cancer. 2000 Apr 1;88(7):1530-5.


Background: Previous epidemiologic studies produced inconsistent results when examining the relation between Helicobacter pylori infection and the risk of gastric carcinoma by measuring various anti-H. pylori antibodies. This study investigated the increased risk of cancer by examining different antibodies, including the specific anti-CagA antibody and antibodies from two commercially available kits.

Methods: An ELISA for the detection of serum anti-CagA was established using a recombinant CagA protein that the authors previously reported. Serum anti-CagA titer was determined for 80 patients with gastric carcinoma and 80 gender- and age-matched controls. Two anti-H. pylori antibodies from the commercially available kits HEL-p (Amrad, Kew Vic, Australia) and HM-CAP (Enteric Product Inc., Westbury, NY) were also evaluated.

Results: Anti-CagA seropositivity differed significantly between gastric carcinoma patients and controls (92.5% vs. 55.0%; P = 0. 0001), showing an odds ratio of 10.4 (95% confidence interval [CI]: 4.23-29.74). The difference was less prominent for the seropositivity of HEL-p (77.5% vs. 58.8%; P = 0.0139; odds ratio: 2. 38; 95% CI: 1.20-4.82) and insignificant for that of HM-CAP (65.0% vs. 57.5%; P = 0.4325; odds ratio: 1.30; 95% CI: 0.68-2.49).

Conclusions: The current study revealed that the antibody assay system used could be one important factor in the assessment of gastric carcinoma risk for patients with H. pylori.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antigens, Bacterial / analysis*
  • Bacterial Proteins / immunology*
  • Bacterial Proteins / metabolism
  • Carcinoma / microbiology*
  • Case-Control Studies
  • Enzyme-Linked Immunosorbent Assay / methods*
  • Female
  • Helicobacter Infections / diagnosis*
  • Helicobacter pylori / immunology*
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Risk
  • Seroepidemiologic Studies*
  • Stomach Neoplasms / microbiology*


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