Helicobacter pylori infection is a major risk factor for gastric carcinomain young patients

Background: Helicobacter pylori has been established as a risk factor for g astric carcinoma (GCa). Since before the discovery of H. pylori, atrophic g astritis and intestinal metaplasia have been Linked to GCa, especially the intestinal-type tumor. The prevalence of H. pylori infection and atrophic g astritis increase with age. Thus, analysis of H. pylori infection in young patients with GCa could help clarify the role of this bacterium in the deve lopment of GCa. Accordingly, we investigated the relationship between H. py lori infection, GCa, and histologic gastritis in patients less than 30 year s old. Methods: Fifty GCa patients less than 30 years (mean, 26.4 years) an d 100 sex- and age-matched controls (mean, 26.8 years) were examined for th e presence of H. pylori infection and histologic gastritis. Results: The pr evalence of H. pylori infection was significantly higher in GCa patients th an in controls (94% versus 40%, P < 0.01). Its prevalence was not associate d with tumor location, tumor stage, or histologic type. Gastritis, atrophy, and intestinal metaplasia significantly increased the risk of GCa. By mean s of multiple logistic regression analysis, the odds ratio for the risk of GCa in H. pylori-positive subjects was found to be 23.5 (95% confidence int erval, 6.84-80.7). Conclusions: We confirmed a strong association between H . pylori infection and GCa in young patients. Along with H. pylori infectio n, histologic gastritis might play an important role in the pathogenesis of GCa in these patients.