Low frequency of cagA-positive Helicobacter pylori strains isolated from Iranian patients with MALT lymphoma

Helicobacter pylori is predominantly involved in the etiology of digestive diseases. The aim of our study is to determine the relationship of cagA frequency with less investigated gastroduodenal disorders such as MALT (mucosal associated lymphoid tissue) lymphoma and gastric cancer. One hundred-twenty eight H. pylori-positive patients including: gastritis (n = 74), gastric cancer (n = 26) and MALT lymphoma (n = 28) were entered in our study. Antral biopsy specimen transport, bacterial culture and cagA detection were performed based on standard protocols. In brief, biopsies from positive H. pylori patients were investigated for presence of cagA gene by polymerase chain reactions (PCR) method. Of 128 consecutive Iranian patients with gastroduodenal disorders examined in our study, we identified 84 (65.6%) cagA-positive strains. However, six patients were excluded because of negative culture for identification of H. pylori. Prevalence of cagA in each categorized groups are following: 63/74 (85.1%) of gastritis patients, 16/28 (57.1%) and 5/26 gastric cancer (19.2%) of MALT lymphoma, respectively. Current findings reveal that the presence of cagA is not a reliable marker for prediction of digestive disorders caused by H. pylori infection. All our patients with gastric cancer were diagnosed as adenocarcinoma. The low rate of cagA among gastric cancer and MALT lymphoma groups was not statistically significant, possibly due to the small number of patients enrolled in the study. We suggest that a study with a high number of patients is needed for making more definitive assessment of the correlation between cagA-positive H. pylori and gastric cancer and MALT lymphoma.