CDH1 and AIDS: C. albicans is able to degrade E-cadherin in vitro [22], which may be a tumor initiating event in the development of gastric signet ring cell carcinoma similar to E-cadherin inactivation by mutations in its gene CDH1. In line with our hypothesis that impaired immune response might lead to an increased risk of gastric cancer, the co-occurrence of C. albicans and signet ring cell carcinoma of the stomach was previously described in a patient with acquired immune deficiency syndrome [23], who as a group have a 1.5-fold increased risk to develop GC [24].