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

Akira Yokoyama, Tetsuji Yokoyama, Tai Omori, Sachio Matsushita, Takeshi Mizukami, Hisao Takahashi, Susumu Higuchi, Katsuya Maruyama, Hiromasa Ishii, Toshifumi Hibi

Research output: Contribution to journalArticlepeer-review

42 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)210-217
Number of pages8
JournalJournal of Gastroenterology and Hepatology (Australia)
Volume22
Issue number2
DOIs
Publication statusPublished - 2007 Feb

Keywords

  • Alcoholism
  • Aldehyde dehydrogenase-2
  • Chronic atrophic gastritis
  • Gastric carcinoma
  • Helicobacter pylori

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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