Department of Epidemiology, College of Public Health, Harbin Medical University, Harbin, Heilongjiang Province, China.
Helicobacter. 2014 Feb;19(1):9-16. doi: 10.1111/hel.12095. Epub 2013 Oct 14.
Helicobacter pylori (H. pylori) infection is a major risk factor for gastric cancer (GC); however, only a minority of infected individuals develops GC. We aim to assess the association between serostatus of antibody against H. pylori flagellin A (FlaA) and risk of GC and to evaluate the value of serum FlaA antibody as a novel screening biomarker for GC risk.
A hospital-based case-control study including 232 cases and 264 controls was conducted. Logistic regression was adopted to analyze the association between the serostatus of FlaA antibody and risk of GC. Serum FlaA antibody was measured by an enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve was used to evaluate the screening efficacy and to identify a cutoff point of serum FlaA antibody level.
Helicobacter pylori infection was associated with an increased risk of GC (p = .007). A positive association between serum FlaA antibody and GC risk was observed in overall subjects and H. pylori-positive subjects (OR [95% CI]: 6.8 [4.3-10.7] and 6.9 [3.6-13.4], respectively; p < .001). The seropositivity of FlaA antibody was strongly related to GC risk in a dose-dependent manner (p for trend < .001). The optimal cutoff value (OD) was 0.1403, providing a sensitivity of 74.1% and a specificity of 64.4%. The area under the ROC curve (AUC) was 0.74 in overall subjects and 0.73 in H. pylori-positive subjects, respectively.
FlaA was an independent risk factor for H. pylori-related GC. Serum FlaA antibody may serve as a novel noninvasive biomarker for early detection of GC.
幽门螺杆菌（H. pylori）感染是胃癌（GC）的主要危险因素；然而，只有少数感染者会发展为 GC。我们旨在评估抗 H. pylori 鞭毛蛋白 A（FlaA）抗体的血清状态与 GC 风险之间的关联，并评估血清 FlaA 抗体作为 GC 风险新型筛查生物标志物的价值。
进行了一项基于医院的病例对照研究，包括 232 例病例和 264 例对照。采用 logistic 回归分析 FlaA 抗体血清状态与 GC 风险之间的关系。采用酶联免疫吸附试验（ELISA）测定血清 FlaA 抗体。采用受试者工作特征（ROC）曲线评估筛查效果，并确定血清 FlaA 抗体水平的截断值。
H. pylori 感染与 GC 风险增加相关（p=0.007）。在总体人群和 H. pylori 阳性人群中，血清 FlaA 抗体与 GC 风险之间存在正相关关系（OR [95%CI]：6.8 [4.3-10.7] 和 6.9 [3.6-13.4]；p<0.001）。FlaA 抗体的血清阳性与 GC 风险呈剂量依赖性相关（p 趋势<0.001）。最佳截断值（OD）为 0.1403，灵敏度为 74.1%，特异性为 64.4%。在总体人群和 H. pylori 阳性人群中，ROC 曲线下面积（AUC）分别为 0.74 和 0.73。
FlaA 是 H. pylori 相关 GC 的独立危险因素。血清 FlaA 抗体可能是 GC 早期检测的新型非侵入性生物标志物。
