Original Contribution
The American Journal of Gastroenterology (2005) 100, 588–593; doi:10.1111/j.1572-0241.2005.40623.x
Helicobacter pylori Infection: A Protective Factor for Esophageal Squamous Cell Carcinoma in a Taiwanese Population
Deng-Chyang Wu MD, PhD1, I-Chen Wu MD1, Jang-Ming Lee MD, PhD1, Hon-Ki Hsu MD1, Ein-Long Kao MD1, Shah-Hwa Chou MD1 and Ming-Tsang Wu MD, SCD1
1Department of Gastroentology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan; Department of Chest Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Chest Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; and Graduate Institute of Occupational Safety and Health and Department of Occupational Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
Correspondence: Ming-Tsang Wu, 100 Shih-Chuan 1st road, Kaohsing, Taiwan, Graduate Institute of Occupational Safety and Health and Department of Occupational Medicine, Kaohsiung Medical University, Kaohsiung
Received 15 April 2004; Revised 0000; Accepted 30 September 2004.
Abstract
AIM:
Many researchers have reported the inverse relationship between Helicobacter pylori (H. pylori) infection and esophageal adenocarcinoma risk, but very few studies have examined the association between H. pylori infection and the development of esophageal squamous-cell carcinoma (ESCC). Therefore, the aim of this study is to evaluate the relationship between H. pylori infection and ESCC risk.
METHOD:
Subjects were cancer cases, pathologically proven to have ESCC, in two large medical centers in Kaohsiung metropolitan of southern Taiwan between August 2000 and May 2003. Controls were from the healthy subjects who lived in Kaohsiung metropolitan and voluntarily participated in one large multiyear of gene-environmental study. In total, 127 cases (116 males and 11 females) and 171 controls (161 males and 10 females) were recruited in the same period of time for interviews. H. pylori seropositivity was determined by an enzyme-linked immunosorbant assay measuring IgG.
RESULTS:
A total of 28 (22.1%) and 74 (43.3%) out of 127 cases and 171 controls, respectively, had positive H. pylori infection. After adjusting for other covariates, subjects with positive H. pylori infections had a significantly reduced risk (adjusted odds ratio (AOR) = 0.51; 95% CI = 0.27–0.96; p= 0.037) of developing ESCC than those without. This result was even more pronounced in the groups of younger subjects, nonsmokers, or nondrinkers. In addition, among the 117 cancer patients who provided information about site of cancer lesion, the present study found that subjects with cancer lesions in the lower third of the esophagus had significantly fewer positive H. pylori infections (AOR = 0.34; 95% CI = 0.14–0.80; p= 0.013) than controls.
CONCLUSION:
Our findings suggest that H. pylori infection may protect against the development of ESCC. Additional studies are needed to confirm these findings.
