CAGA PROTEIN SEROPOSITIVITY IN A RANDOM SAMPLE OF ADULT-POPULATION AND GASTRIC-CANCER PATIENTS IN ESTONIA

Objective The prevalence of antibodies to CagA protein, associated wit h the risk of developing gastric cancer (GC), was studied in an Estoni an adult population with a high prevalence of Helicobacter pylori (HP) infection and in a group of GC patients. Design In a representative s ample of a random adult population from the South Estonian town of Kar ksi-Nuia, containing 199 subjects (86 M, 113 F, mean age 42.4) and in 45 (22 M, 23 F, mean age 64.5) consecutive patients with gastric adeno carcinoma, recruited during the periods 1986-87 and 1995-96 in the Hos pital of Oncology, University of Tartu, anti-CagA IgG antibodies were determined by enzyme-linked immunosorbent assay (ELISA) using a recomb inant fragment of CagA protein. The occurrence of anti-CagA IgG in ELI SA was compared with immunoblot results for 141 subjects. Results Sero positivity to acid glycine extracted cell surface proteins of HP was 8 5% in the population and 91% in GC patients (p = 0.39). Anti-CagA IgG antibodies were present in 63% of the population and in 87% of GC pati ents (p = 0.004). The highest prevalence of anti-CagA IgG in the popul ation sample occurred in the age group 20-29 (76%). A comparison of an ti-CagA positivity evaluated by using ELISA and immunoblot showed an a greement of results in 80% of cases.Conclusion HP seropositivity was s imilarly high in the Estonian random adult population sample and in GC patients, however, the prevalence of anti-CagA IgG was significantly higher in GC patients. Moreover, persons aged 20-29 years in the popul ation possess the highest prevalence of anti-CagA IgG and should be gi ven further attention with respect to the development of GC later in l ife.