• Osamu Toyoshima, Toshihiro Nishizawa, Kosuke Sakitani, Tadahiro Yamakawa, Yoshiyuki Takahashi, Nobutake Yamamichi, Keisuke Hata, Yasuyuki Seto, Kazuhiko Koike, Hidenobu Watanabe, and Hidekazu Suzuki.
• Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan. t@ichou.com.
• World J. Gastroenterol. 2018 Sep 21; 24 (35): 4061-4068.

AimTo clarify the role of serum anti-Helicobacter pylori (H. pylori) antibody titers in gastric cancer.MethodsIn this cross-sectional study, the effect of patients' baseline characteristics and endoscopic findings on their serum antibody titers were assessed. We evaluated consecutive patients who underwent esophagogastroduodenoscopy and their first evaluation for H. pylori infection using a serum antibody test. We excluded patients with a history of eradication therapy. The participants were divided into four groups according to their E-plate serum antibody titer. Patients with serum antibody titers < 3, 3-9.9, 10-49.9, and ≥ 50 U/mL were classified into groups A, B, C, and D, respectively.ResultsIn total, 874 participants were analyzed with 70%, 16%, 8.7%, and 5.1% of them in the groups A, B, C, and D, respectively. Patients in group C were older than patients in groups A and B. Gastric open-type atrophy, intestinal metaplasia, enlarged folds, diffuse redness, and duodenal ulcers were associated with a high titer. Regular arrangements of collecting venules, fundic gland polyps, superficial gastritis, and gastroesophageal reflux disease were related to a low titer. Multivariate analysis revealed that nodularity (P = 0.0094), atrophy (P = 0.0076), and age 40-59 years (vs age ≥ 60 years, P = 0.0090) were correlated with a high serum antibody titer in H. pylori-infected patients. Intestinal metaplasia and atrophy were related to age ≥ 60 years in group C and D.ConclusionSerum antibody titer changes with age, reflects gastric mucosal inflammation, and is useful in predicting the risk of gastric cancer.

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