A Genetic and Immunohistochemical Analysis of H. Pylori Phenotypes and p27 expression in Adenocarcinoma Patients in Jordan

Gastric cancer is one of the most prevalent malignant cancers worldwide and specifically, adenocarcinoma. Based on prior research, there is an association between Helicobacter pylori (H. pylori) infection and the frequency of duodenal ulcer, distal gastric adenocarcinoma, mucosa-associated lymphoid tissue lymphoma, and antral gastritis. H. pylori virulence and toxicity factors have been identified that significantly influence the clinical outcomes of H. pylori infection and gastric adenocarcinoma. However, it is unclear exactly how different strains of H. pylori infection affect gastric adenocarcinoma. Current research suggests this involves tumor suppressor genes, like p27, but also H. Pylori toxic proteins. Therefore, we quantified known H. Pylori genotypes within adenocarcinoma patients to establish the prevalence of known toxins that include cytotoxin-associated gene A (cagA) and vacuolating cytotoxin A (vacA) within patients of variable diagnosis. This analysis used gastrectomy samples which were validated for DNA viability. The incidence of H. Pylori in adenocarcinoma patients in Jordan was established to be 54.5% positive (ureA gene) with cagA genotype occurrence at 57.1% but also vacA gene ratios 24.7%:22.1%: 14.3%:14.3%. (vacAs1:vacAs2: vacAm1:vacAm2). It is statistically significant that p27 was dysregulated and suppressed within nearly all H. Pylori vacA genotypes but also that according to our analysis that 24.6% of H. Pylori samples analyzed had an a different bacterial genotype and curiously that p27 protein expression was still retained in 12% of tested adenocarcinoma H. Pylori samples which is suggestive that p27 could be used as a prognostic indicator but also that an un-known genotype could be contributing to the regulatory effects of p27 protein within this bacterial and cellular environment. Key Contribution This is the first study to use validated viable gastrectomy tissue samples rather than tissue biopsies which characterized each of the currently defined H. pylori strains in patients with variable gastric cancer diagnosis whilst also comparing with p27 expression. Conclusions Based on these results, a reduction in p27 expression in H. pylori-infected men and women of all ages may be associated with the occurrence of gastric adenocarcinomas in those individuals. Therefore, p27 is regarded in such individuals as a key diagnostic marker and a predictor of adenocarcinoma prognosis evaluation and subsequent treatment.