Immunoblotting using multiple antigens is essential to demonstrate the true risk of Helicobacter pylori infection for gastric cancer
Article first published online: 4 JUL 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 28, Issue 7, pages 903–910, October 2008
How to Cite
MITCHELL, H., ENGLISH, D. R., ELLIOTT, F., GENGOS, M., BARRETT, J. H., GILES, G. G. and FORMAN, D. (2008), Immunoblotting using multiple antigens is essential to demonstrate the true risk of Helicobacter pylori infection for gastric cancer. Alimentary Pharmacology & Therapeutics, 28: 903–910. doi: 10.1111/j.1365-2036.2008.03792.x
- Issue published online: 1 SEP 2008
- Article first published online: 4 JUL 2008
- Publication data Submitted 3 June 2008 First decision 23 June 2008 Resubmitted 25 June 2008 Resubmitted 30 June 2008 Accepted 30 June 2008 Epub Accepted Article 4 July 2008
Background Enzyme-linked immunosorbent assays (ELISAs) for detection of Helicobacter pylori infection, using IgG antibodies, may significantly underestimate the association with gastric cancer.
Aim To compare associations between H. pylori and cardia (CGC) and noncardia gastric cancer (NCGC) using ELISA and immunoblotting and determine the effect of atrophic gastritis on detection.
Methods Nested case–control study within the Melbourne Collaborative Cohort Study. Helicobacter pylori antibodies were detected in subjects with CGC (n = 18), NCGC (n = 34) and controls (n = 69 and 134 respectively) using ELISA (pylori DTect) and immunoblot (Helicoblot 2.1). Pepsinogen I levels were measured using ELISA.
Results Using ELISA, H. pylori-positivity in the CGC group was 33% vs. 35% in controls [odds ratio (OR = 0.9, 95% CI: 0.3–2.7)], while that in the NCGC group was 79% vs. 63% in controls [OR = 2.3 (95% CI: 0.9–5.8)]. Based on immunoblotting, H. pylori-positivity in the CGC group was 44% vs. 39% in their controls [OR = 1.2 (95% CI: 0.4–3.4)], while that in the NCGC group was 94% vs. 63% in controls [OR = 10.6 (95% CI: 2.4–47.4)]. Pepsinogen I levels in the NCGC cases and controls showed the lowest median level (4 ng/mL) to be in subjects negative by ELISA but positive by immunoblotting.
Conclusion Immunoblotting improves the accuracy of H. pylori studies involving gastric cancer.