Helicobacter pylori infection and low serum pepsinogen I level as risk factors for gastric carcinoma

World J Gastroenterol. 2005 Feb 21;11(7):1032-6. doi: 10.3748/wjg.v11.i7.1032.


Aim: To study whether examination of CagA antibodies could increase the odds ratio for gastric cancer in a case-control study, and how often other serum markers of gastric cancer risk could be found in Helicobacter pylori -negative patients.

Methods: H pylori CagA and parietal cell antibodies (PCAs), and serum pepsinogen I (SPGI) levels were compared between patients with gastric cancer and controls who received endoscopic examination due to reasons other than gastrointestinal malignancy.

Results: The odds ratio (OR) for gastric cancer was 2.9 (95% CI 1.4-5.8) in H pylori + patients, and 2.4 (95% CI 1.2-4.9) in CagA+ patients. When results of H pylori and CagA antibodies were combined, OR increased to 5.0 (95% CI 2.5-10.0). Furthermore, if cardia cancer patients were excluded, the OR increased to 6.8 (95% CI 3.1-14.8). Among patients with a low SPGI level, the OR was 12.0 (95% CI 4.1-35.3). However, the risk was significant only in the older age group. The number of patients with low SPGI was significantly higher in H pylori -/CagA+ patients as compared to other cancer patients.

Conclusion: Examination of both H pylori and CagA antibodies increases the OR for gastric cancer in our case-control study. CagA antibodies are important in detecting previous H pylori infection in advanced atrophic gastritis or cancer when spontaneous decline of H pylori antibodies occurs. SPGI may be helpful in screening elderly gastric cancer patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / blood
  • Antigens, Bacterial / immunology
  • Autoantibodies / blood
  • Bacterial Proteins / immunology
  • Biomarkers
  • Case-Control Studies
  • Female
  • Helicobacter Infections / blood
  • Helicobacter Infections / epidemiology*
  • Helicobacter pylori*
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Parietal Cells, Gastric / immunology
  • Pepsinogen A / blood*
  • Risk Factors
  • Seroepidemiologic Studies
  • Stomach Neoplasms / blood
  • Stomach Neoplasms / epidemiology*


  • Antibodies, Bacterial
  • Antigens, Bacterial
  • Autoantibodies
  • Bacterial Proteins
  • Biomarkers
  • cagA protein, Helicobacter pylori
  • Pepsinogen A