The Relationship between Helicobacter Pylori Virulence Factors and Gastric Carcinoma

Background: Helicobacter pylori is a gram-negative microaerophilic bacterium found usually in the stomach and use several mechanisms to survive in the stomach lumen. The presence of these bacteria in the stomach can lead to gastritis and reduction in stomach acid production. Aim of the work: this study aimed to investigate the seroprevalence of six highly immunogenic virulence factors (Cag A, Vac A, Gro EL, gGT, Hcp C and Ure A) in patients with different gastric histology in a high-risk population of gastric cancer and explore the relationship between H. pylori virulence factors and gastric carcinoma. Methods: this study included 100 patients: 25 patients were diagnosed histopathologically as gastric cancer (Group I) and 75 patients were diagnosed endoscopically as mild gastritis (Group II). Their samples were collected from Military Armed Hospitals. Noninvasive serologic test was performed to detect immune responses to H. pylori by stool antigen test, ELISA and by Recomoline H. pylori test. Results: on comparing results of gastric carcinoma and chronic gastritis by Recomoline H. pylori test, it was found that Cag A was detected in 88% (22/25) in group I. While, in group II it was 57.33% (43/75) of cases and Vac A was detected in 80% (20/25) in group I while, it was in group II in 44% (33/75) of cases. Gro EL was detected in 72% (18/25) in group I while; it was 49.33% (37/75) group II and Urea A was 52% (13/25) in group I while, it was 52% (39/75) in group II. Hcp c was 56% (14/25) in group I while, it was 40% (30/75) in group II and gGT was 48% (12/25) in group I while, it was 34.67% (26/75) in group II. Conclusion: in this study, a statistically significant association was found between Cag A, Vac A and Gro EL antigen in the studied groups of patients. However, no such statistically significant association was found between Urea A, Hcp c and gGT antigen. (P value > 0.05). Thus, Cag A, Vac A and Gro EL antigen proved to be virulence markers for gastric carcinoma group.