Background & aims: Although Helicobacter pylori has already been declared a human carcinogen, the exact nature of the association with gastric cancer remains to be explored. The aim of this study was to determine if the association is confined to specific types of gastric cancer.
Methods: The prevalence of H. pylori immunoglobulin G antibodies (HM-CAP immunoassay; Enteric Products Inc., Westbury, NY) was determined in prospectively collected sera from 279 patients with gastric cancer.
Results: The overall prevalence of H. pylori seropositivity was 77%. The prevalence of H. pylori infection was significantly lower among patients with tumors of the gastric cardia compared with those with other gastric locations. Age-adjusted H. pylori seroprevalence among patients with the intestinal type of gastric cancer tended to be higher than among those with the diffuse type according to Laurén (P > 0.05). In both histological types, the seroprevalence decreased with increasing age. Multivariate logistic regression analysis showed that high age and proximal tumor location were independent predictors of absence of H. pylori.
Conclusions: The association with H. pylori infection is similar regardless of the histological features of the tumor, whereas it is stronger for noncardiac gastric cancer than for cardiac cancer. The apparent loss of H. pylori seropositivity among patients with gastric cancer is determined by age rather than tumor stage.