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It is estimated that approximately 0.1% of people infected with\n                      <jats:italic>H. pylori<\/jats:italic>\n                      develop gastric MALT lymphoma. However, the role of the CagA antigen, the highest causative agent of\n                      <jats:italic>H. pylori<\/jats:italic>\n                      , in increasing the risk of gastric MALT lymphoma remains unclear and controversial. A systematic review and meta-analysis were conducted to evaluate the effect of\n                      <jats:italic>cagA<\/jats:italic>\n                      status on the development of gastric MALT lymphoma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All articles evaluating the status of the\n                      <jats:italic>cagA<\/jats:italic>\n                      gene in the development of gastric MALT lymphoma were collected using systematic searches in online databases, including PubMed, Scopus, Embase, and Google Scholar, regardless of publication date. The association between\n                      <jats:italic>cagA<\/jats:italic>\n                      and gastric MALT lymphoma was assessed using the odds ratio (OR) summary. In addition, a random-effects model was used in cases with significant heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 10 studies met our inclusion criteria, among which 1860 patients participated. No association between\n                      <jats:italic>cagA<\/jats:italic>\n                      status and the development of MALT lymphoma (extranodal marginal zone B-cell lymphoma) was found in this study (OR 1.30; 0.906\u20131.866 with 95% CIs;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      : 45.83;\n                      <jats:italic>Q<\/jats:italic>\n                      -value: 12.92). Surprisingly, a meaningful association was observed between\n                      <jats:italic>cagA<\/jats:italic>\n                      status and diffuse large B-cell lymphoma (OR 6.43; 2.45\u201316.84 with 95% CIs). We also observed an inverse association between\n                      <jats:italic>vacA<\/jats:italic>\n                      and gastric MALT lymphoma risk (OR 0.92; 0.57\u20131.50 with 95% CIs).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      It seems that the infection with\n                      <jats:italic>cagA<\/jats:italic>\n                      -positive\n                      <jats:italic>H. pylori<\/jats:italic>\n                      strains does not have a meaningful effect on the gastric MALT lymphoma formation, while translocated CagA antigen into the B cells plays a crucial role in the development of diffuse large B-cell lymphoma.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41043-021-00280-9","type":"journal-article","created":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T07:03:43Z","timestamp":1641193423000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Helicobacter pylori cagA status and gastric mucosa-associated lymphoid tissue lymphoma: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"41","author":[{"given":"Masoud","family":"Keikha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirhossein","family":"Sahebkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Yamaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9899-2885","authenticated-orcid":false,"given":"Mohsen","family":"Karbalaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"issue":"3","key":"280_CR1","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1128\/CMR.00054-05","volume":"19","author":"JG Kusters","year":"2006","unstructured":"Kusters JG, Van Vliet AH, Kuipers EJ. 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