VacAgenotypes andcagA-EPIYA-Cmotifs ofHelicobacter pyloriand gastric histopathological lesions

Helicobacter pyloriinfection induces inflammation of the gastric mucosa, which may progress to precancerous lesions and gastric cancer. The gastric histo-pathological damages may be associated with some virulence genes of the bacterium, notablyvacAandcagAgenes. To establish correlations between these genes and the lesions, biopsies from 1303 adults consenting patients that were previously analyzed by PCR to characterizevacA-svacA-m,vacA-iregions andcagA3 ' region polymorphism, were used. The highest average age was obtained in patients with intestinal metaplasia (53.65 +/- 15.26 years) and gastric cancer (53.60 +/- 14.32 years). Thus, these lesions are more frequent in elderly and male subjects. Tobacco smoking was significantly associated with neutrophilic activity (P= .02). No significant association was obtained between patients with chronic inflammation andvacAandcagA H. pylorigenotypes. However, a significant association has been obtained between this lesion andcagA+ in aged patients (P= .02), while intestinal metaplasia was significantly associated withvacAi1andvacAm1separately (P < .01 and .01). Also, a significant association was obtained between intestinal metaplasia and strains with one EPIYA-C motif in young patients (P= .001). Interestingly, a significant association was obtained between gastric cancer andcagA+,vacAi1,vacAm1 H. pylorigenotypes and also with two EPIYA-C motifs independently of age groups (allP < .05). The results of our study show thatH. pylori vacAi1could be more potent than the otherH. pylorivirulent factors for predicting the precancerous gastric lesions, confirming that this gene may be helpful to identify patients at high risk for gastric cancer.