HELICOBACTER-PYLORI SEROLOGY IN PATIENTS WITH GASTRIC-CARCINOMA

Helicobacter pylori-associated gastritis has been put forward as a dis tinct risk factor for gastric cancer. Furthermore, among H. pylori-pos itive individuals a correlation between a high serum level of H. pylor i antibodies and the risk of gastric cancer has been found in two diff erent studies. Other studies have challenged this hypothesis. We there fore studied the presence and level of H. pylori serum antibodies, usi ng an enzyme-linked immunosorbent assay technique in 116 gastric cance r patients (65 men; mean age, 67 years; range, 23-92 years) and 116 co ntrols matched for age and sex. Patients and controls were selected on referral for gastroscopy. The prevalence of infection in gastric canc er patients was 77% (89 of 116) and in controls 79% (92 of 116). This difference is not statistically significant, nor is the prevalence of infection in cases and controls of different age cohorts significantly different. High levels of serum antibodies were found in 46% (53 of 1 16) of gastric cancer patients and 40% (46 of 116) of controls. Compar ison of the prevalence of high serum levels of antibodies for the tota l population and for the different age cohorts did not show significan t differences either. We conclude that the comparison of actual H. pyl ori infection in a cross-sectional study of gastric cancer patients an d controls does not enable relative risk calculation in the study of t he role of H. pylori infection in gastric carcinogenesis. Prospective studies showing diminishment of the risk for gastric cancer after erad ication of H. pylori are required.