Virulent strains vary in the expression of cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA), two of the most prominent virulence factors of H. pylori that contribute to inflammation, with these particularly aggressive strains (VacA and CagA positive [+]) linked to higher risk of GC and peptic ulcer disease (50–52) . This evidence concerns the gene S100A8 and gastric cancer.