TY - JOUR
T1 - Helicobacter pylori, chronic atrophic gastritis, inactive aldehyde dehydrogenase-2, macrocytosis and multiple upper aerodigestive tract cancers and the risk for gastric cancer in alcoholic Japanese men
AU - Yokoyama, Akira
AU - Yokoyama, Tetsuji
AU - Omori, Tai
AU - Matsushita, Sachio
AU - Mizukami, Takeshi
AU - Takahashi, Hisao
AU - Higuchi, Susumu
AU - Maruyama, Katsuya
AU - Ishii, Hiromasa
AU - Hibi, Toshifumi
PY - 2007/2
Y1 - 2007/2
N2 - Background: Gastric carcinoma occurs at a high rate in alcoholic Japanese men. Inactive heterozygous aldehyde dehydrogenase-2 (ALDH2*1/2*2) and macrocytosis (mean corpuscular volume [MCV] ≥ 106 fl) enhance the risk for esophageal carcinoma, which frequently occurs with gastric carcinoma in this population. Whether alcoholism affects Helicobacter pylori-induced chronic atrophic gastritis (CAG) is unknown. Methods: This study of Japanese alcoholic men with (n = 45) and without (n = 281) gastric carcinoma included assessment of H. pylori IgG antibody, serum pepsinogen-confirmed CAG, MCV, and ALDH2 genotype. Results: The gastric carcinoma cases had a significantly higher age-adjusted prevalence of H. pylori-positivity (78% vs 57%), CAG (78% vs 42%), ALDH2*1/2*2 (36% vs 14%), MCV ≥106 fl (38% vs 20%), and concurrent esophageal/oropharyngolaryngeal carcinoma (18% vs 5%) than controls. Among gastric cancer-free controls, the prevalence of CAG was higher than generally reported in Japan, regardless of H. pylori status (H. pylori-positive, 56% vs 35-36% for Japanese general population; H. pylori-negative, 8% vs 1-3%). Alcoholism may accelerate the progression of CAG. Each of these factors increased the risk of gastric carcinoma (ORs = 3.7 for H. pylori-positive, 2.7 for non-severe CAG, 8.7 for severe CAG, 3.5 for ALDH2*1/2*2, 2.5 for MCV ≥106 fl, and 3.7 for concurrent carcinoma). A multivariate analysis showed that CAG and ALDH2*1/2*2 were independently related to the risk of gastric carcinoma. Combinations of CAG and ALDH2*1/2*2 showed greater risks of gastric carcinoma (OR s = 4.0 for non-severe CAG alone, 17.6 for severe CAG alone, 9.7 for ALDH2*1/2*2 alone, 17.1 for non-severe CAG plus ALDH2*1/2 *2, and 39.2 for severe CAG plus ALDH2*1/2*2). Conclusions: Combining blood tests for H. pylori, CAG, MCV and ALDH2 genotype could offer a new means of predicting risk of gastric carcinoma in Japanese alcoholic men.
AB - Background: Gastric carcinoma occurs at a high rate in alcoholic Japanese men. Inactive heterozygous aldehyde dehydrogenase-2 (ALDH2*1/2*2) and macrocytosis (mean corpuscular volume [MCV] ≥ 106 fl) enhance the risk for esophageal carcinoma, which frequently occurs with gastric carcinoma in this population. Whether alcoholism affects Helicobacter pylori-induced chronic atrophic gastritis (CAG) is unknown. Methods: This study of Japanese alcoholic men with (n = 45) and without (n = 281) gastric carcinoma included assessment of H. pylori IgG antibody, serum pepsinogen-confirmed CAG, MCV, and ALDH2 genotype. Results: The gastric carcinoma cases had a significantly higher age-adjusted prevalence of H. pylori-positivity (78% vs 57%), CAG (78% vs 42%), ALDH2*1/2*2 (36% vs 14%), MCV ≥106 fl (38% vs 20%), and concurrent esophageal/oropharyngolaryngeal carcinoma (18% vs 5%) than controls. Among gastric cancer-free controls, the prevalence of CAG was higher than generally reported in Japan, regardless of H. pylori status (H. pylori-positive, 56% vs 35-36% for Japanese general population; H. pylori-negative, 8% vs 1-3%). Alcoholism may accelerate the progression of CAG. Each of these factors increased the risk of gastric carcinoma (ORs = 3.7 for H. pylori-positive, 2.7 for non-severe CAG, 8.7 for severe CAG, 3.5 for ALDH2*1/2*2, 2.5 for MCV ≥106 fl, and 3.7 for concurrent carcinoma). A multivariate analysis showed that CAG and ALDH2*1/2*2 were independently related to the risk of gastric carcinoma. Combinations of CAG and ALDH2*1/2*2 showed greater risks of gastric carcinoma (OR s = 4.0 for non-severe CAG alone, 17.6 for severe CAG alone, 9.7 for ALDH2*1/2*2 alone, 17.1 for non-severe CAG plus ALDH2*1/2 *2, and 39.2 for severe CAG plus ALDH2*1/2*2). Conclusions: Combining blood tests for H. pylori, CAG, MCV and ALDH2 genotype could offer a new means of predicting risk of gastric carcinoma in Japanese alcoholic men.
KW - Alcoholism
KW - Aldehyde dehydrogenase-2
KW - Chronic atrophic gastritis
KW - Gastric carcinoma
KW - Helicobacter pylori
UR - http://www.scopus.com/inward/record.url?scp=33846676802&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33846676802&partnerID=8YFLogxK
U2 - 10.1111/j.1440-1746.2006.04377.x
DO - 10.1111/j.1440-1746.2006.04377.x
M3 - Article
C2 - 17295873
AN - SCOPUS:33846676802
SN - 0815-9319
VL - 22
SP - 210
EP - 217
JO - Journal of Gastroenterology and Hepatology (Australia)
JF - Journal of Gastroenterology and Hepatology (Australia)
IS - 2
ER -
