ASPO Abstracts

Helicobacter pylori Blood Biomarkers and Gastric Cancer Survival in China

Authors: Varga MG, Wang T, Cai H, Xiang YB, Gao YT, Ji B, Pawlita M, Waterboer T, Zheng W, Shu XO, Epplein M

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research, Molecular Epidemiology & Environment
Conference Year: 2018

Abstract Body:
Purpose: Infection with Helicobacter pylori is the leading risk factor for non-cardia gastric cancer, yet its influence on prognosis of gastric cancer is largely unknown. Thus, exploring the role of H. pylori in survival could lead to a greater understanding of the high mortality associated with gastric cancer. Methods: Sero-positivity to 15 H. pylori antigens was assessed using a multiplex assay in two prospective cohorts, the Shanghai Men’s Health Study and the Shanghai Women’s Health Study. Multivariable-adjusted Cox proportional hazards regression was used to examine the association between pre-diagnostic H. pylori antigen levels and gastric cancer-specific survival. Results: Pre-diagnostic levels of H. pylori serum antibodies that were previously associated with gastric cancer incidence in this population were not associated with gastric cancer survival, whether assessed in a 6-antigen panel (HR 1.29, 95% CI 0.78-2.13 for men; HR 0.93, 95% CI 0.57-1.52 for women), focused on the cancer-associated toxin CagA+ H. pylori (HR 1.27, 95% CI 0.70-2.31 for men; HR 0.73, 95% CI 0.44-1.20 for women) or on the high cancer-risk H. pylori blood biomarkers of dual Omp and HP 0305 sero-positivity (HR 1.37 95% CI .97-1.94 for men; HR 0.97, 95% CI 0.72-1.30 for women). Adjustment for or stratification by previously established factors associated with gastric cancer survival, including tumor stage and treatment, did not alter these null findings. Conclusions: We conclude that pre-diagnostic H. pylori antigen levels are not associated with gastric cancer survival in East Asian populations. Therefore, identification of additional factors associated with gastric cancer survival would further our understanding of the high mortality associated with this malignancy.

Keywords: Helicobacter pylori; Gastric Cancer; Survival; multiplex serology