Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2017; 23(8): 1443-1449
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1443
Helicobacter pylori infection with intestinal metaplasia: An independent risk factor for colorectal adenomas
Ye Yan, Yi-Na Chen, Qian Zhao, Chao Chen, Chun-Jing Lin, Yin Jin, Shuang Pan, Jian-Sheng Wu
Ye Yan, Yi-Na Chen, Qian Zhao, Chao Chen, Yin Jin, Shuang Pan, Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Chun-Jing Lin, Jian-Sheng Wu, Medical and Health Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Yan Y designed and performed the research and wrote the paper; Chen YN, Zhao Q, and Chen C collected the data and designed the research; Lin CJ, Jin Y, Pan S, and Wu JS provided clinical advice and supervised the report.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board and the Ethics Committee of The First Affiliated Hospital of Wenzhou Medical University.
Informed consent statement: The requirement for informed consent was waived because we retrospectively accessed de-identified data only.
Conflict-of-interest statement: The authors declare that there is no conflict of interest with the paper presented.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Jian-Sheng Wu, Professor, Medical and Health Care Center, The First Affiliated Hospital of Wenzhou Medical University, No. 1 Nan Bai Xiang street, Wenzhou 325000, Zhejiang Province, China. wzwujs@163.com
Telephone: +86-577-55578033 Fax: +86-577-55578033
Received: October 14, 2016
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
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: Helicobacter pylori, Chinese population, Colorectal neoplasms, Intestinal metaplasia, Chronic gastritis

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.