Helicobacter pylori Infection and Serum Pepsinogen Level With the Risk of Gastric Precancerous Conditions: A Cross-sectional Study of High-risk Gastric Cancer Population in China. Issue 9 (October 2021)

• Record Type: Journal Article
• Authors: Zhou, Xianzhu; Zhu, Huiyun; Zhu, Chunping; Lin, Kun; Cai, Quancai; Li, Zhaoshen; Du, Yiqi
• Is Part Of: Journal of clinical gastroenterology. Volume 55:Issue 9(2021)
• Publication Date: 2021-10
• Subjects: Helicobacter pylori -- precancerous conditions -- stomach -- cross-sectional study; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000001444
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Background and Aim: Gastric precancerous conditions are generally considered to play an essential role in the gastric carcinogenesis cascade. This study identified risk factors of gastric precancerous conditions in a nationwide multicenter cross-sectional study. Methods: Individuals who made their visit to 115 hospitals in China for gastric cancer screening were recruited. Lifestyle habits and personal information were collected through a series of questionnaires. Serum biomarker test (pepsinogen I, pepsinogen II, gastrin-17, and anti- Helicobacter pylori immunoglobulin G antibody) and endoscopy were then performed. Risk factors for gastric precancerous conditions were identified by univariate and multivariate analyses. Results: Of 14, 929 subjects eligible for analysis, 4477 (30.0%) developed gastric precancerous conditions and 405 (2.71%) developed gastric cancer. In multiple logistic regression, precancerous conditions were associated with advanced age [odds ratio (OR)=1.027; 95% confidence interval (Cl), 1.023-1.032; P <0.001], male gender (OR=1.303; 95% Cl, 1.188-1.429; P <0.001), H. pylori infection (OR=1.377; 95% Cl, 1.272-1.490, P <0.001), and smoking (OR=1.142; 95% Cl, 1.005-1.298, P =0.004), whereas they were inversely correlated with white meat intake (OR=0.731; 95% Cl, 0.673-0.794; P <0.001) and pepsinogen I level (30 to 70 subgroup OR=1.536; 95% Cl, 1.163-2.028; P =0.002; <30 subgroup OR=1.354; 95% Cl, 1.206-1.520; P <0.001). Also, the authors observed a statistically lower prevalence of reflux esophagitis (2.8% vs. 4.7%) and of gastric polyps (11.0% vs. 13.7%) in H. pylori- infected population. Conclusions: Patients with H. pylori have a 1.4-fold higher risk of having gastric precancerous conditions. Besides, precancerous conditions were associated with advanced age, male gender, H. pylori infection, and smoking in a large population. However, regular white meat intake and higher pepsinogen I level were associated with reduced risk of having precancerous lesions. Abstract : Supplemental Digital Content is available in the text.