Abstract：
The objective of this meta-analysis is to delineate the association between H. pylori CagA serological status and the prevalence of gastric precancerous lesions (GPL). We searched peer-reviewed articles up to October 2023. The extraction of data from the included studies was carried out as well as the quality assessment. Pooled effect sizes were calculated using a random effect model. Thirteen studies met the inclusion criteria, comprising 2728 patients with GPL and 17 612 controls. The aggregate odds ratio (OR) for the association between serum CagA and GPL was 2.74 (95% CI = 2.25-3.32; P = 0.00; I 2 = 60.4%), irrespective of H. pylori infection status. Within the H. pylori -infected cohort, the OR was 2.25 (95% CI = 1.99-2.56; P = 0.00; I 2 = 0.0%). Conversely, among the non-infected individuals, the OR was 1.63 (95% CI = 1.04-2.54; P = 0.038; I 2 = 0.0%). Heterogeneity was explored using subgroup and meta-regression analyses, indicating that the variability between studies likely stemmed from differences in disease classification. Our results demonstrated robustness and negligible publication bias. The meta-analysis underscores a more pronounced association between H. pylori CagA seropositivity and the risk of developing GPL than between seronegativity and the same risk, irrespective of H. pylori infection status at the time. Additionally, the strength of the association was heightened in the presence of an active H. pylori infection. The implications of these findings advocate for the utility of CagA serostatus as a potential biomarker for screening GPL.
摘要：
这项荟萃分析的目的是描述幽门螺杆菌CagA血清学状态与胃癌前病变（GPL）患病率之间的关系。我们搜索了截至2023年10月的同行评审文章。从纳入的研究中提取数据并进行质量评估。使用随机效应模型计算集合效应大小。13项研究符合纳入标准，包括2728例GPL患者和17612例对照。血清CagA与GPL之间关联的总比值比（OR）为2.74（95％CI=2.25-3.32；P=0.00；I2=60.4％），无论幽门螺杆菌感染状况如何。在幽门螺杆菌感染队列中，OR为2.25（95％CI=1.99-2.56；P=0.00；I2=0.0％）。相反，在非感染者中，OR为1.63（95％CI=1.04-2.54；P=0.038；I2=0.0％）。使用亚组和荟萃回归分析探索异质性，这表明研究之间的差异可能源于疾病分类的差异。我们的结果表明了稳健性和可忽略的发表偏倚。荟萃分析强调了幽门螺杆菌CagA血清阳性与发生GPL的风险之间的关系，而不是血清连贯性与相同风险之间的关系，无论当时的幽门螺杆菌感染状况如何。此外,在存在活动性幽门螺杆菌感染的情况下,关联强度增强.这些发现的意义主张CagA血清状态作为筛选GPL的潜在生物标志物的效用。
