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Background: Peroxisome proliferator-activated receptor gamma (PPAR[gamma]) is a ligand-dependent transcription factor involved in various disease processes including inflammation and carcinogenesis. We investigated the association of Pro12Ala PPAR[gamma] polymorphism and Helicobacter pylori infection with gastric cancer and peptic ulcer disease (PUD).

Patients and methods: In total, 348 adult patients [62 gastric adenocarcinoma, 45 PUD and 241 nonulcer dyspepsia (NUD)] who underwent an upper gastrointestinal endoscopy were enrolled. PPAR[gamma] polymorphism was analyzed by PCR-based restriction fragment length polymorphism. H. pylori infection was diagnosed by rapid urease test, culture, histopathology and PCR.

Results: PPAR[gamma] G carrier had significant association with gastric adenocarcinoma [P=0.023, odds ratio (OR)=2.136, 95% CI=1.112-4.104] and PUD (P=0.028, OR=2.165, 95% CI=1.008-4.306) when compared with NUD. Combination of G carrier and H. pylori infection further increased the risk of gastric adenocarcinoma (OR=3.054, 95% CI=1.195-7.807) and PUD (OR=11.161, 95% CI=3.495-35.644). PPAR[gamma] polymorphism did not increase the risk of gastric adenocarcinoma and PUD in H. pylori-negative subjects.

Conclusions: The study suggests that Pro12Ala PPAR[gamma] polymorphism is associated with gastric adenocarcinoma and PUD, and is a potential marker for genetic susceptibility to these two diseases in the presence of H. pylori infection.

(C) 2008 The European Society for Medical Oncology