Relationship between Helicobacter Pylori Infection and the Risk of Esophageal Cancer in Thailand

Document Type : Research Articles


1 Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.

2 Department of Pathology, Faculty of Medicine, Khon Kaen Universtity, Khon Kaen, Thailand.

3 Department of Medical Science, Amnatcharoen Campus, Mahidol University, Amnatcharoen, Thailand.


Objective: Esophageal cancer (EC) is a multifactorial disease and a leading cause of mortality. Epidemiological and molecular studies have provided evidence that Helicobacter pylori (H. pylori) infection is an important cause of gastric carcinogenesis and thus, may be related to EC. However, esophagus H. pylori infection in Thai patients with newly diagnosed EC has not been reported. Moreover, the evidence of the association with H. pylori to EC is controversial. This study investigated the possible association between H. pylori infection with a virulence gene and EC in Thailand. Methods: A case-control study was conducted that involved 105 newly diagnosed EC patients and 108 healthy controls. The prevalence of H. pylori infection detected in formalin-fixed, paraffin-embedded EC tissue in esophageal biopsy specimens from the subjects was measured using real-time PCR. All the data were collected in face to face interviews using a structured questionnaire. Multivariable unconditional logistic regression was used to calculate and analyses the odds ratios (ORs) of the data. Results: A significant association was found between H. pylori infection and EC (p < 0.001, 95% CI:3.11–10.48). H. pylori-positive subjects had a 2.76 times higher risk of developing ESCC. Moreover, the H. pylori-positive subjects who were CagA-positive had slightly higher ORs and statistically significant risk factors. Conclusions: H. pylori infection was found to be associated with a risk of EC in Thailand, and among the H. pylori-positive subjects who were CagA-positive had a higher risk factor of ESCC but not of EAC.


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