Association of cagA , cagC , virB2 , and vacA Subtypes of Helicobacter pylori with Adenocarcinoma Development in Iranian Patients

Background: Gastric cancer has been introduced as the second cause of cancer death worldwide. Helicobacter pylori infection is considered one of the main risk factors for this type of cancer, so that it has been classified as group I carcinogens. Objectives: The present research intended to examine the prevalence of cagA, cagC, virB2, vacA, and genotype distribution in H. pylori-infected biopsies and adenocarcinoma cases. Methods: Thirty-four H. pylori gastric biopsies taken from Western Iranian patients that were diagnosed as gastritis, gastric ulcers, and adenocarcinoma were used in this study. Two samples were taken from each patient. These samples were selected based on endoscopic observations and histological examinations. The presence of H. pylori was confirmed by the Rapid Urease test (RUT) and the ureC gene by the polymerase chain reaction (PCR) technique. Then, specific primers for vacA and cagPAI were used for genotyping H. pylori by PCR-typing. Results: The obtained results showed that 86.8% of the samples were H. pylori-positive. Moreover, the cagA gene prevalence was 51.50% in the samples. In addition, the adenocarcinoma outcome was significantly related to all selected genes. Likewise, some gastric diseases such as gastric ulcers, duodenal ulcer (DU), gastritis, lymphoid, and gastroesophageal reflux disease (GERD) were observed in adenocarcinoma cases. It was also found that the vacAs1m1i1 genotype plays an important role in gastric malignancies. The most frequent vacA genotype in the H. pylori-infected isolates was s1m1i1, and the observed frequency of vacA and cagA genes in adenocarcinoma was statistically significant. Conclusions: The findings showed that H. pylori vacA and cagA gene virulence factors are associated with adenocarcinoma in Western Iranian patients.