ANTI-CAGA ANTIBODIES ARE ASSOCIATED WITH ATROPHIC GASTRITIS IN A POPULATION AT HIGH GASTRIC-CANCER RISK - A MORPHOMETRIC STUDY BY COMPUTERIZED IMAGE-ANALYSIS

Background, CagA-positive Helicobacter pylori strains appear to increa se the risk for atrophic gastritis. Aim, To verify the association bet ween CagA status and atrophic gastritis in the general population by m eans of computerized image analysis. Subjects, Forty-jive subjects wer e chosen out of a representative sample of a population at high gastri c cancer risk. Methods, Helicobacter pylori status was assessed by IgG ELISA, rapid urease test and histology. Serum anti-CagA antibodies we re detected by western blotting. Subjects were subdivided into 3 group s. 15 subjects Helicobacter pylori positive CagA-positive, 15 Helicoba cter pylori positive CagA-negative and 15 controls Helicobacter pylori negative. Biopsies were studied using the Sydney System score. A comp uterized image analysis was used to count inflammatory cells in the la mina propria and to measure the area of the gastric glands. Results. A nti-CagA antibodies were associated with reduction of gland area (1266 71 +/- 81032 mu(2)/mm(2) vs 231384 +/- 54159; p = 0.0001), with increa sing both of polymorphonuclear cells (426 +/- 238 cell/mm(2) vs 136 +/ - 69; p = 0.0001) and mononuclear cells (8675 +/- 1304 cell/mm(2) vs 7 241 +/- 1230; p = 0.003). Conclusions. The association of anti-CagA an tibodies with a high grade of gastric atrophy further supports the hyp othesis that Helicobacter pylori CagA-positive strains can promote the multifactorial process of gastric carcinogenesis.