Gastric Tumor Suppressor Genes Alterations Associated with cag A Positive H pylori among Patients with Gastric Cancer Systemic Review and Meta-Analysis

Abstract

Abuobaida Alwasila, Mubarak Elnour, Nazar Abdelaziz

Introduction: Gastric cancer is the fifth most frequent cancer worldwide After lung, breast, colorectal, and prostate cancers. Helicobacter pylori (H. pylori) is considered the most important causative agent of gastrointestinal diseases such as peptic ulcer, gastritis, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma.

Objective: to identify the tumor suppressor genes alterations associated with CagA in patients with gastric cancer.

Methods: All the available papers published before 2022 were collected by searching in PubMed and Scopus. The keywords included in the research were “H.pylori”, “gastric cancer”, “virulence factors”, “tumor suppressor genes” “ gene mutations” “cagA+” used by Boolean operators to obtain the articles with the keywords in their titles or abstracts.

Result: Initial searches yielded 111 articles, four articles were excluded as a duplication using the computer program Zotero (v5), then one hundred and seven articles were screened for the title and abstract evaluation using the Rayyan website, among them seventy-one articles were excluded. Thirty-six articles were scanned for full-text review and eligibility, furthermore, twenty-five articles were excluded because there were either Reviews and case reports, Not relevant studies, Insufficient data, and Unclear methods and results. Eleven articles were included for the literature review. In addition, the studies were in different regions of the world including Asia, Europe, North America, and Latin America. However, most of the studies were related to the USA.

Conclusion: Cag A can cause alterations on gastric tumor suppressor genes by either decreased expression by increasing the methylation, inducing point mutation as mentioned, inactivation by increasing the methylation levels, increasing the levels of deg- radation and methylation the promotor of the tumor suppressor gene as mentioned.

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