Helicobacter pylori (Hp) alone cannot account for development of atrophic gastritis and intestinal metaplasia in a high gastric cancer risk region in China

Background: In areas with high prevalence of Helicobacter pylori (Hp) infection and high gastric cancer mortality such as China and Japan, Hp status is not a good marker for increased risk of gastric cancer.The increased risk associated with CagA+ Hp strains are controversial in these areas as well.Hong Kong has a moderate to high prevalence of Hp infection and a gastric cancer mortality of 7.9/105 population.We examine the relationship between Hp, particularly CagA+ strains, and gastric cancer in Hong Kong adults.Methods: Sera from 52 patients (29 male and 23 females, mean age 59.8 yrs) with non-cardiac type of gastric cancer and 52 age and sex matched asymptomatic controls were examined for anti-Hp antibody by using the commercial ELISA kit (Bio-rad, USA).CagA status was determined by an anti-CagA antibody assay using a purified recombinant CagA fusion protein as antigen using the method described(Am