Plasma pepsinogens, antibodies against Helicobacter pylori, and risk of gastric cancer in the Shanghai Women's Health Study Cohort

Br J Cancer. 2011 Apr 26;104(9):1511-6. doi: 10.1038/bjc.2011.77. Epub 2011 Mar 15.

Abstract

Background: Circulating pepsinogens can indicate atrophic gastritis, a precursor of gastric cancer. We tested the association between gastric cancer and plasma pepsinogens and antibodies against Helicobacter pylori in a case-control study nested in a prospective cohort.

Methods: We selected 141 gastric cancer cases and 282 incidence-density sampled controls. Plasma concentrations of pepsinogens 1 and 2 were measured using ELISA kits, and anti-H. pylori antibodies were measured using a kit specific to Chinese strains. Associations were estimated using conditional logistic regression models adjusted for potential confounders.

Results: Gastric cancer subjects were more likely to be anti-H. pylori positive than controls, 97 vs 92%. A plasma pepsinogen 1 (PG1) concentration <50 ng ml(-1) (15% of cases) was associated with a significantly increased risk of gastric cancer (OR 4.23; (95% CI: 1.86-9.63), whereas a plasma pepsinogen 2 (PG2) concentration >6.6 ng ml(-1) (75% of cases) was also associated with a significantly increased risk of gastric cancer (OR 3.62; (95% CI: 1.85-7.09). We also found that the PG1 : 2 ratio had a nearly linear association with gastric cancer risk.

Conclusion: Lower plasma PG1 : 2 ratios are associated with a higher risk of gastric cancer. Furthermore, it appears that circulating pepsinogens 1 and 2 may be independently associated with the risk of gastric cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Aged
  • Antibodies, Bacterial / blood*
  • Asian Continental Ancestry Group / statistics & numerical data*
  • Biomarkers, Tumor / blood
  • Case-Control Studies
  • China / epidemiology
  • Cohort Studies
  • Confounding Factors, Epidemiologic
  • Female
  • Helicobacter Infections / complications*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / immunology*
  • Humans
  • Linear Models
  • Middle Aged
  • Pepsinogen A / blood
  • Pepsinogen C / blood
  • Pepsinogens / blood*
  • Stomach Neoplasms / enzymology*
  • Stomach Neoplasms / epidemiology
  • Stomach Neoplasms / microbiology*
  • Women's Health

Substances

  • Antibodies, Bacterial
  • Biomarkers, Tumor
  • Pepsinogens
  • Pepsinogen C
  • Pepsinogen A