{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T07:00:23Z","timestamp":1763535623562,"version":"3.40.5"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T00:00:00Z","timestamp":1562284800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007073","name":"University of Mohaghegh Ardabili","doi-asserted-by":"publisher","award":["95","13","14100"],"award-info":[{"award-number":["95","13","14100"]}],"id":[{"id":"10.13039\/501100007073","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Iran is a high\u2010risk country for cardia gastric adenocarcinoma (CGA) in Central Asia, with an incidence rate five times the average global rate, and shows a high infection rate for <jats:italic>Helicobacter pylori<\/jats:italic> (69%). The aim was to examine the associations of multiple <jats:italic>H. pylori cag<\/jats:italic>PAI genotypes (ie <jats:italic>cagH<\/jats:italic>, <jats:italic>cagL<\/jats:italic>, <jats:italic>cagG<\/jats:italic>, and <jats:italic>orf17<\/jats:italic>) with the risk of CGA, non\u2010CGA, and different histological types of GA in Iran. A large number of <jats:italic>H. pylori<\/jats:italic> strains (N\u00a0=\u00a0336) were successfully cultured and genotyped. Histopathological evaluations were performed. The analysis showed an inverse association between the <jats:italic>cagH<jats:sup>+<\/jats:sup><\/jats:italic> genotype and the risk of CGA and intestinal\u2010type gastric adenocarcinoma (IGA) (adjusted ORs; 0.312 and 0.283, respectively), where the controls were nontumors. The <jats:italic>orf17<\/jats:italic><jats:sup>+<\/jats:sup> genotype decreased the risk of non\u2010CGA and diffuse\u2010type gastric adenocarcinoma (DGA)(adjusted ORs; 0.310 and 0.356, respectively). When the controls were those with nonatrophic gastritis, the <jats:italic>cagG<\/jats:italic><jats:sup>+<\/jats:sup> genotype was negatively associated with the risk of CGA, non\u2010CGA, IGA, and DGA (adjusted ORs; 0.324, 0.366, 0.306, and 0.303, respectively). We did not find such a significant association for the <jats:italic>cagL<jats:sup>+<\/jats:sup><\/jats:italic> genotype in multiple logistic regression analysis. Combination of the <jats:italic>vacA<\/jats:italic> c2 and <jats:italic>cag<\/jats:italic>PAI genotypes further decreased the risk estimates for GAs. This study showed the reverse association of <jats:italic>H. pylori cag<\/jats:italic>PAI genotypes\u2014<jats:italic>cagH<\/jats:italic><jats:sup>+<\/jats:sup> and <jats:italic>cagG<\/jats:italic><jats:sup>+<\/jats:sup>\u2014with the risk of CGA in male patients aged\u00a0\u2265\u00a055 in Iran. Presence of the <jats:italic>vacA<\/jats:italic> c2 genotype in combination with <jats:italic>cag<\/jats:italic>PAI genotypes showed strong inverse associations with the risk of CGA and non\u2010CGA. These findings may reveal a coordinated relationship between the <jats:italic>vacA<\/jats:italic> c2 and <jats:italic>cag<\/jats:italic>PAI genotypes.<\/jats:p>","DOI":"10.1002\/cam4.2390","type":"journal-article","created":{"date-parts":[[2019,7,5]],"date-time":"2019-07-05T08:59:47Z","timestamp":1562317187000},"page":"4928-4937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Inverse association of <i>Helicobacter pylori cag<\/i>PAI genotypes with risk of cardia and non\u2010cardia gastric adenocarcinoma"],"prefix":"10.1002","volume":"8","author":[{"given":"Seyedeh Zahra","family":"Bakhti","sequence":"first","affiliation":[{"name":"Department of Biology, Faculty of Sciences University of Mohaghegh Ardabili Ardabil 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