Helicobacter pylori infection with intestinal metaplasia: An independent risk factor for colorectal adenomas

World J Gastroenterol. 2017 Feb 28;23(8):1443-1449. doi: 10.3748/wjg.v23.i8.1443.

Abstract

Aim: To explore the association between Helicobacter pylori (H. pylori) infection status, intestinal metaplasia (IM), and colorectal adenomas.

Methods: We retrospectively reviewed 1641 individuals aged ≥ 40 years who underwent physical examination, laboratory testing, 13C-urea breath testing, gastroscopy, colonoscopy, and an interview to ascertain baseline characteristics and general state of health. Histopathological results were obtained by gastric and colorectal biopsies.

Results: The prevalence of H. pylori infection and adenomas was 51.5% (845/1641) and 18.1% (297/1641), respectively. H. pylori infection was significantly correlated with an increased risk of colorectal adenomas (crude OR = 1.535, 95%CI: 1.044-1.753, P = 0.022; adjusted OR = 1.359, 95%CI: 1.035-1.785, P = 0.028). Individuals with IM had an elevated risk of colorectal adenomas (crude OR = 1.664, 95%CI: 1.216-2.277, P = 0.001; adjusted OR = 1.381, 95%CI: 0.998-1.929, P = 0.059). Stratification based on H. pylori infection stage and IM revealed that IM accompanied by H. pylori infection was significantly associated with an increased risk of adenomas (crude OR = 2.109, 95%CI: 1.383-3.216, P = 0.001; adjusted OR = 1.765, 95%CI: 1.130-2.757, P = 0.012).

Conclusion: H. pylori-related IM is associated with a high risk of colorectal adenomas in Chinese individuals.

Keywords: Chinese population; Chronic gastritis; Colorectal neoplasms; Helicobacter pylori; Intestinal metaplasia.

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Breath Tests
  • Colonoscopy
  • Colorectal Neoplasms / pathology
  • Gastric Mucosa / pathology
  • Gastritis / pathology
  • Gastroscopy
  • Helicobacter Infections / complications*
  • Helicobacter pylori
  • Humans
  • Intestines / microbiology*
  • Intestines / pathology*
  • Metaplasia / complications*
  • Metaplasia / microbiology
  • Metaplasia / pathology
  • Middle Aged
  • Prevalence
  • Regression Analysis
  • Retrospective Studies
  • Risk Factors
  • Stomach / pathology
  • Treatment Outcome