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; I2 = 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; I2 = 0.0%). Conversely, among the non-infected individuals, the OR was 1.63 (95% CI = 1.04-2.54; P = 0.038; I2 = 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.

中文翻译：

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幽门螺杆菌 CagA 血清阳性与胃癌前病变的关联：系统评价和荟萃分析。

本荟萃分析的目的是描绘幽门螺杆菌 CagA 血清学状态与胃癌前病变 (GPL) 患病率之间的关联。我们检索了截至 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汇总效应大小。 13 项研究符合纳入标准，其中包括 2728 名 GPL 患者和 17 612 名对照者。无论幽门螺杆菌感染状态如何，血清 CagA 和 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%）。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，在未感染个体中，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讨异质性，表明研究之间的变异性可能源于疾病分类的差异。我们的结果证明了稳健性和可忽略的发表偏差。荟萃分析强调，无论当时的幽门螺杆菌感染状况如何，幽门螺杆菌 CagA 血清阳性与发生 GPL 的风险之间的关联性，比血清阴性与相同风险之间的关联性更为明显。此外，当存在活跃的幽门螺杆菌感染时，这种关联的强度会增强。这些发现表明 CagA 血清状态可作为筛查 GPL 的潜在生物标志物。