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Abstract

OBJECTIVE: To detect the presence of virulence markers cytotoxin-associated (cagA) and vacuolating cytotoxin-associated (vacA) genes in gastric biopsy specimens of patients with gastroduodenal disorders. METHODS: This study was conducted at the Department of Pathology, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between March 2008 and February 2009. A total of 118 gastric biopsy specimens from 81 males and 37 females (mean age: 55 ± 18 years) with histological evidence for the presence of Helicobacter pylori (H. pylori) were included in the study. The H. pylori cagA and vacA genes were detected using polymerase chain reaction-enzyme-linked immunosorbent assay technique. RESULTS: Both H. pylori cagA and vacA genes were detected in 60 (51%) patients. Forty-one (35%) patients had active chronic gastritis, 22 (54%) harbored cagA, and 25 (61%) had vacA gene. Twenty-six (22%) patients had duodenal ulcer, 14 (54%) had cagA, and 15 (58%) had vacA genes. Eighteen (15%) patients had active acute gastritis, 8 (44%) carrying cagA gene, and 12 (67%) had vacA gene. The cagA and vacA genes co-existed in all the 17 (100%) patients with adenocarcinoma. These genes coexisted in 44% biopsies from active acute gastritis, and 46% each in duodenal ulcer and active chronic gastritis. CONCLUSION: The cagA and vacA genes as H. pylori virulence markers were detected in gastroduodenal disorders, and their remarkably high co-existence in adenocarcinoma prompt further investigations for evaluating H. pylori as a direct carcinogen.

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Research Article

First Page

716

Last Page

721

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