Helicobacter pylori vacA, iceA, and cagA status and pattern of gastritis in patients with malignant and benign gastroduodenal disease

OBJECTIVE: Both bacterial virulence factors and the pattern of Helicobacter pylori (H. pylori) gastritis may contribute to the development of clinical ly relevant gastroduodenal disease. The aim of our study was to investigate the frequency of H. pylori vacA alleles, iceA, and cagA, and the pattern o f gastritis in patients with gastric cancer (GC), gastric lymphoma (MALT), duodenal ulcer (DU), and functional dyspepsia (FD). METHODS: H. pylori was cultured from 141 patients (34 GC, 26 MALT, 49 DU, 3 2 FD). Allelic variants of vacA and iceA, and cagA were identified by polym erase chain reaction. Antrum and corpus biopsies were obtained for assessme nt of gastritis according to the updated Sydney System. RESULTS: The vacA s1,m1 genotype was more frequently detected in H. pylori from GC patients (70.6%) than from MALT, DU, and FD patients (p < .05). The frequency of iceA1 and cagA did not differ among the groups. The proportio n of patients with severe gastritis in the corpus was significantly higher in patients with GC and MALT compared with patients with DU (p <0.001). CONCLUSIONS: In a German patient population, only the vacA s1,m1 genotype o f H. pylori is associated with GC, and therefore may be useful to identify infected patients being at an increased risk for GC. (Am J Gastroenterol 20 01;96:1008-1013. (C) 2001 by Am. Coll. of Gastroenterology).