Detection of H.pylori in a Group of Iraqi Patients with Colonic Cancer (Histological and Molecular Study)

Abstract

ABSTRACT:BACKGROUND: H. pylori is a one of the gastrointestinal organism which infects more than half the population of the world. H.pylori had been recognized as a class I human carcinogen by the International Agency for Research on Cancer. Recently H. pylori were detected in the mucosa of normal colon. Certain studies suggested a possible relationship between CagA (Cytotoxin Associated Gene A) positive H.pylori and Colonic Cancer while other studies did not find causal relationship between CagA positive H.pylori and Colonic Cancer. OBJECTIVE: We studied and isolated H.pylori from at or near by the site of lesion of Colonic Cancer and it is found to assess a possible relationship between CagA positive H.pylori and Colonic Cancer.PATIENTS AND METHODS: Study involved 30 patients of colonoscopically and Histopathologicaly determined Colonic Cancer (CC group) compared with patients with normal colon (n=90) as a control group (NC group). Patients divided into <20 years age group, 20-40 years age group and >40 years age group. Endoscopic specimens were tested for Biopsy Urease Test (BUT) and Hematoxylin & Eosin (H&E) method for detection of H. pylori also the detection of CagA mRNA using In Situ Hybridization technique with a biotin labeled probe.RESULTS: There was 66.7% H.pylori positive in patients with Colonic Cancer (by BUT) and 60% by (H&E) compared to 33.3% (by BUT) and 26.7% (H&E) in patients with normal colon (Control). A comparison between NC&CC groups regarding H.pylori infection using H&E method revealed significant difference (P=0.001).Using In Situ Hybridization technique, there was 66.7% CagA positive H.pylori in CC group in correspondence to 25% in NC group. CagA positive H.pylori infection between CC and NC groups revealed significant difference (P=0.008)CONCLUSION: H.pylori detected at or near by the site of lesion of Colonic Cancer. In addition it was found that there is a statistical relationship between CagA positive H.pylori infection and Colonic Cancer which suggested a possible role of CagA positive H.pylori in Colonic Cancer.