Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1443
Peer-review started: October 19, 2016
First decision: December 2, 2016
Revised: December 14, 2016
Accepted: January 4, 2017
Article in press: January 4, 2017
Published online: February 28, 2017
To explore the association between Helicobacter pylori (H. pylori) infection status, intestinal metaplasia (IM), and colorectal adenomas.
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.
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).
H. pylori-related IM is associated with a high risk of colorectal adenomas in Chinese individuals.
Core tip: This retrospective study revealed Helicobacter pylori (H. pylori)-related intestinal metaplasia (IM) to be an independent risk factor for colorectal adenomas in Chinese individuals aged ≥ 40 years. Clinically, it may be useful for patients with H. pylori infection and IM to undergo colonoscopy screening and surveillance.