Serum VacA antibody is associated with risks of peptic ulcer and gastric cancer: A meta-analysis

• This was the first meta-analysis investigating the predictive role of serum VacA antibody and gastric diseases.
• By analyzing the data extracted from 29 articles, we deemed that serum VacA antibody was related with risks of PUD, GU or DU.
• Likewise, significant association was also found between serum VacA antibody and GC risk.
• Serum VacA antibody might be a potential biomarker for the prediction of risks of PUD, GU, DU and GC.

BackgroundIncreasing studies have investigated the relationship between the status of H. pylori vacA antibody and risks of peptic ulcer disease (PUD) and gastric cancer (GC). However, the results were controversial. The aim of this meta-analysis is to clarify whether serum vacA antibody is associated with risks of PUD and GC.MethodsDatabases including PubMed, Embase, Web of knowledge, Wanfang, Chinese National Knowledge Infrastructure (CNKI), OVID, Karger and Scopus were systematically searched for potentially eligible literature. Odds ratios (OR) and their 95% confidence interval (CI) were adopted to assess the strength of association.ResultsSerum VacA antibody was associated with increased risk of PUD compared with gastritis/functional dyspepsia (FD) (OR = 1.96, 95%CI = 1.56–2.46, P < 0.001). Serum VacA antibody was significantly associated with increased risk of gastric ulcer (GU) and duodenal ulcer (DU) compared with gastritis/FD (GU: OR = 1.64, 95%CI = 1.02–2.62, P = 0.042; DU: OR = 2.06, 95%CI = 1.50–2.84, P < 0.001, respectively). Significant increased risk of GC was found in serum VacA antibody positive subjects compared with serum VacA antibody negative individuals (OR = 2.78, 95%CI = 1.98–3.89, P < 0.001). There was no significant publication bias in all of the comparisons.ConclusionsSerum VacA antibody was significantly associated with increased risks of peptic ulcer disease, gastric ulcer and duodenal ulcer compared with gastritis and functional dyspepsia controls. Significant association was also found between serum VacA antibody and gastric cancer risk. Serum VacA antibody might be a potential biomarker for the prediction of risks of PUD and GC.