Helicobacter pylori cag Pathogenicity Island cagL and orf17 Genotypes Predict Risk of Peptic Ulcerations but not Gastric Cancer in Iran

Background: Gastric cancer (GC) is the third most common cancer regarding mortality in the world. Thecag pathogenicity island (PAI) of Helicobacter pylori which contains genes associated with a more aggressivephenotype may involve in the pathogenesis of gastrointestinal disease. We here aimed to examine the associationsof cagH, cagL, orf17, and cagG genotypes of H. pylori cag PAI with severe gastrointestinal disease. Materialsand
Methods: A total of 242 H. pylori strains were genotyped. Histopathological examination and classificationof subjects were performed.
Results: The frequencies of the cagH, cagL, cagG, and orf17 genotypes were 40/54(74.1%), 53/54 (98.1%), 38/54 (70.4%), and 43/54 (79.6%), respectively, in patients with peptidic ulceration(PU),while in the control group, the frequencies were 87/147 (59.6%) for cagH, 121/146 (82.9%) for cagL, 109/146(74.7%) for cagG, and 89/146 (61.0%) for orf17. The results of simple logistic regression analysis showed that thecagL and orf17 genotypes were significantly associated with an increased risk of PU not GC; the ORs (95% CI)were 10.950 (1.446-82.935), and 2.504 (1.193-5.253), respectively. No significant association was found betweenthe cagH and cagG genotypes and the risk of both the PU and the GC in Iran (P>0.05). Finally, multiple logisticregression analysis showed that the cagL genotype was independently and significantly associated with the ageandsex-adjusted risk for PU; the OR (95% CI) was 9.557 (1.219-17.185).
Conclusions: We conclude that theorf17 and especially cagL genotypes of H. pylori cag PAI could be factors for risk prediction of PU, but not GCin Iran.