The Helicobacter pylori vacA sl, ml genotype and cagA is associated with gastric carcinoma in Germany

Background: The H. pylori vacuolating cytotoxin encoded by vacA and the cyt otoxin-associated protein encoded by cagA are considered to be important vi rulence determinants that have been implicated in the development of peptic ulcers and gastric carcinoma. However, conflicting results regarding the a ssociation between these virulence factors and clinical disease have been r eported from different geographic regions. Aims: To determine the frequency of vacA genotypes, vacuolating cytotoxin activity, and cagA in H. pylori i solates obtained from patients with gastric cancer in Germany. Methods: H. pylori isolates were obtained from 34 patients with gastric cancer and from 35 subjects with asymptomatic H. pylori gastritis, vacA genotypes and cagA were identified by PCR, Cytotoxic activity was determined by HeLa cell ass ays. Gastritis was assessed according to the updated Sydney System. Results : The H. pylori vacA sI,mI genotype was significantly more frequent in pati ents with gastric cancer (24/34, 70.6%) as compared with controls (12/35, 3 4.3%) (p = 0.005). Cytotoxic activity was detected in 24 (70.6%) and 15 (42 .9%) H. pylori isolates from gastric cancer patients and controls, respecti vely (P = 0.03). The cagA gene was identified in 30 (88.2%) and 21 (60%) H. pylori isolates in the respective groups (p = 0.01). Conclusions: Our stud y suggests a significant association between the H. pylori vacA sI,mI genot ype, cytotoxic activity, cagA, and gastric cancer. Detection of H. pylori p ossessing these virulence determinants may help to identify patients being at an increased risk to develop gastric cancer in our population. Int. J. C ancer 87:322-327, 2000. (C) 2000 Wiley-Liss, Inc.