CagA in Barrett's oesophagus in Colombia, a country with a high prevalence of gastric cancer

J Clin Pathol. 2005 Mar;58(3):259-62. doi: 10.1136/jcp.2004.022251.


Background: In the USA, atrophic gastritis and gastric cancer are rare, whereas gastro-oesophageal reflux disease (GERD) is common. Infection with Helicobacter pylori, especially a CagA positive strain, is unusual in patients with GERD/Barrett's oesophagus in the USA.

Aim: To examine the relation between Barrett's oesophagus and CagA positive H pylori in Colombia, a country with a high prevalence of CagA positive H pylori associated atrophic gastritis and gastric cancer.

Methods: Helicobacter pylori and CagA status was determined among Colombian patients with long segment Barrett's oesophagus and a control group with simple H pylori gastritis. Helicobacter pylori status was determined using a triple stain and CagA status was determined by immunohistochemistry using a specific rabbit anti-CagA serum.

Results: Gastric and oesophageal mucosal biopsies were obtained from 51 patients--39 men (mean age, 57.8 years; SD, 13.1) and 12 women (mean age, 51.8 years; SD, 14.4)--with documented long segment Barrett's oesophagus. The results were compared with 24 Colombian patients with H pylori gastritis without oesophageal disease. Thirty two patients with Barrett's oesophagus had active H pylori infection. CagA status was evaluated in a subset of 23 H pylori infected patients with Barrett's oesophagus, and was positive in eight of these patients compared with 19 of 24 controls (p = 0.01).

Conclusions: Although most Colombian patients with Barrett's oesophagus had H pylori infection, CagA positive infections were unusual. These data illustrate how consistent corpus inflammation reduces acid secretion, which prevents Barrett's oesophagus among those with abnormal gastro-oesophageal reflux barriers.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Animals
  • Antigens, Bacterial / analysis*
  • Bacterial Proteins / analysis*
  • Barrett Esophagus / ethnology
  • Barrett Esophagus / microbiology*
  • Barrett Esophagus / pathology
  • Colombia / epidemiology
  • Female
  • Gastric Mucosa / pathology
  • Gastritis / microbiology
  • Helicobacter Infections / complications*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / chemistry*
  • Helicobacter pylori / classification
  • Humans
  • Male
  • Metaplasia
  • Middle Aged
  • Precancerous Conditions / ethnology
  • Precancerous Conditions / microbiology
  • Precancerous Conditions / pathology
  • Prevalence
  • Rabbits
  • Stomach Neoplasms / ethnology
  • Stomach Neoplasms / microbiology*
  • Stomach Neoplasms / pathology


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