Wang Xiao-Qin, Terry Paul D, Cheng Li, Yan Hong, Wang Jian-Sheng, Wu Wen-An, Hu Sen-Ke
Xiao-Qin Wang, Hong Yan, Department of Statistics and Epidemiology, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
World J Gastroenterol. 2014 Jul 7;20(25):8151-7. doi: 10.3748/wjg.v20.i25.8151.
To explore potential interactions among Helicobacter pylori (H. pylori), CagA status, interleukin (IL)-1B-31 genotypes, and non-cardiac gastric cancer (GC) risk.
A case-control study of non-cardia GC was performed at 3 hospitals located in Xi'an, China, between September 2008 and July 2010. We included 171 patients with histologically diagnosed primary non-cardia GC and 367 population based controls (matched by sex, age and city of residence). A standardized questionnaire was used to obtain information regarding potential risk factors, including pork consumption. H. pylori CagA status was assessed by enzyme-linked immunosorbent assay, and IL-1B-31 genotypes were determined by polymerase chain reaction-restriction fragment length polymorphism. Multivariate unconditional logistic regression was used to explore potential interactions among the factors.
The CagA appeared to confer an increased risk of GC (OR = 1.81, 95%CI: 1.25-2.61). The main associations with IL-1B-31C allele here were 0.98 (95%CI: 0.59-1.63) for CC vs TT and 0.99 (95%CI: 0.64-1.51) for C Carriers vs TT. However, no associations were observed for CagA or IL-1B-31 genotype status among subjects who reported low pork consumption (P for interaction = 0.11). In contrast, high pork consumption and IL-1B-31C genotypes appeared to synergistically increase GC risk (P for interaction = 0.048) after adjusting for confounding factors, particularly among subjects with CagA (OR = 3.07, 95%CI: 1.17-10.79). We did not observe effect modification of pork consumption by H. pylori CagA status, or between H. pylori CagA status and IL-1B-31 genotypes after adjustment for pork consumption and other factors.
These interaction relationships among CagA, IL-1B-31 and pork consumption may have implications for development of the preventive strategies for the early detection of non-cardiac GC.
探讨幽门螺杆菌(H. pylori)、细胞毒素相关蛋白A(CagA)状态、白细胞介素(IL)-1β-31基因型与非贲门胃癌(GC)风险之间的潜在相互作用。
2008年9月至2010年7月期间,在中国西安的3家医院进行了一项非贲门GC的病例对照研究。我们纳入了171例经组织学诊断为原发性非贲门GC的患者和367名基于人群的对照者(按性别、年龄和居住城市匹配)。使用标准化问卷获取包括猪肉消费在内的潜在危险因素信息。通过酶联免疫吸附测定评估H. pylori CagA状态,通过聚合酶链反应-限制性片段长度多态性确定IL-1β-31基因型。采用多变量无条件逻辑回归来探讨这些因素之间的潜在相互作用。
CagA似乎会增加GC风险(比值比[OR]=1.81,95%置信区间[CI]:1.25 - 2.61)。此处与IL-1β-31 C等位基因的主要关联为CC与TT相比为0.98(95%CI:0.59 - 1.63),C携带者与TT相比为0.99(95%CI:0.64 - 1.51)。然而,在报告低猪肉消费量的受试者中,未观察到CagA或IL-1β-31基因型状态的关联(交互作用P值=0.11)。相比之下,在调整混杂因素后,高猪肉消费量和IL-1β-31 C基因型似乎会协同增加GC风险(交互作用P值=0.048),特别是在携带CagA的受试者中(OR = 3.07,95%CI:1.17 - 10.79)。在调整猪肉消费和其他因素后,我们未观察到H. pylori CagA状态对猪肉消费的效应修饰,或H. pylori CagA状态与IL-1β-31基因型之间的效应修饰。
CagA、IL-1β-31和猪肉消费之间这些相互作用关系可能对制定非贲门GC早期检测的预防策略具有启示意义。