H Pylori
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2008; 14(10): 1498-1503
Published online Mar 14, 2008. doi: 10.3748/wjg.14.1498
Polymorphism of -765G > C COX-2 is a risk factor for gastric adenocarcinoma and peptic ulcer disease in addition to H pylori infection: A study from northern India
Ashish Saxena, Kashi Nath Prasad, Uday Chand Ghoshal, Monty Roshan Bhagat, Narendra Krishnani, Nuzhat Husain
Ashish Saxena, Kashi Nath Prasad, Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
Uday Chand Ghoshal, Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
Monty Roshan Bhagat, Department of Gastroenterology, Central Command Hospital, Lucknow 226002, India
Narendra Krishnani, Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India
Nuzhat Husain, Department of Pathology, Chhatrapati Shahu Ji Maharaj Medical University, Lucknow 226001, India
Author contributions: Saxena A had primary responsibility for protocol development, patients screening, enrolment, outcome assessment, preliminary data analysis and writing the manuscript; Prasad KN supervised the design and execution of the study, and contributed to the writing of the manuscript; Ghoshal UC and Bhagat MR participated in the development of the protocol and analytical framework for the study, patient screening, and contributed to the writing of the manuscript; Krishnani N and Hussain N have performed the histological analysis of the samples.
Correspondence to: Kashi Nath Prasad, Professor, Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, India. knprasad@sgpgi.ac.in
Telephone: +91-522-2668631
Fax: +91-522-2668017
Received: November 3, 2007
Revised: January 29, 2008
Published online: March 14, 2008
Abstract

AIM: To investigate -765G > C COX-2 polymorphism and H pylori infection in patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and non-ulcer dyspepsia (NUD).

METHODS: We enrolled 348 adult patients (62 gastric adenocarcinoma, 45 PUD and 241 NUD) undergoing upper gastrointestinal endoscopy at two referral centers between September, 2002 and May, 2007. H pylori infection was diagnosed when any of the four tests (RUT, culture, histopathology and PCR) were positive. Genotyping for -765G > C polymorphism of COX-2 was performed by PCR-RFLP analysis.

RESULTS: Frequency of C carrier had significant association with gastric adenocarcinoma as compared to NUD [77.4% vs 29%, P < 0.001, odds ratio (OR) 8.20; 95% confidence interval (95% CI), 4.08-16.47] and PUD (77.4% vs 31.1%, P < 0.001; OR 8.04; 95% CI, 3.25-19.90). Risk of gastric adenocarcinoma was significantly higher in patients having C carrier with (OR 7.83; 95% CI 3.09-19.85) and without H pylori infection (OR 7.06; 95% CI, 2.61-19.09). Patients with C carrier and H pylori infection had significant risk for the development of PUD (P < 0.001; OR 5.65; 95% CI, 2.07-15.34).

CONCLUSION: -765G > C COX-2 polymorphism with or without H pylori could be a marker for genetic susceptibility to gastric adenocarcinoma. COX-2 polymorphism in presence of H pylori infection might be useful in predicting the risk of PUD.

Keywords: COX-2 polymorphism; Gastric adenocarcinoma; Peptic ulcer disease; Helicobacter pylori infection