Published online Oct 7, 2020. doi: 10.3748/wjg.v26.i37.5682
Peer-review started: April 21, 2020
First decision: May 1, 2020
Revised: May 29, 2020
Accepted: September 9, 2020
Article in press: September 9, 2020
Published online: October 7, 2020
Several previous studies demonstrated the significance of Helicobacter pylori (H. pylori) infection and atrophic gastritis (AG) in the prevalence of colorectal adenomas. A recent study showed a significant association between colorectal neoplasm and AG, which was diagnosed by Kimura and Takemoto criteria without the histologic diagnosis. However, the relationship between AG and colorectal neoplasia, especially that between H. pylori-related AG and colorectal neoplasia, is still controversial.
Colorectal adenomas may develop colorectal cancer, which is considered to be one of the most common human malignancies worldwide. Early diagnosis of colorectal adenomas is important to reduce mortality. The association of H. pylori infection and AG in the prevalence of colorectal adenomas has been examined in a limited number of studies. However, there exists disputed conclusions in the studies reported.
The aim was to investigate the relationship between colorectal adenomas and H. pylori-related AG based on the histologic diagnosis.
This retrospective cross-sectional study analyzed records between August 2014 and August 2017 and were extracted from the Medical and Health Care Center at The First Affiliated Hospital of Wenzhou Medical University. Based on the relevant inclusion and exclusion criteria, 6018 health-check individuals were eventually enrolled. The relevant data were recorded. Univariate and multivariate logistic regression analyses were performed to determine the association between H. pylori-related AG and colorectal adenomas.
H. pylori infection accompanied by AG was significantly associated with an increased risk of adenomas (adjusted odds ratio = 1.491, 95% confidence interval: 1.103-2.015, P = 0.009) and advanced adenomas (adjusted odds ratio = 1.910, 95% confidence interval: 1.022-3.572, P = 0.043).
Our research demonstrated that H. pylori-related AG is an independent risk factor for colorectal adenomas in the Chinese population.
The Chinese have a high prevalence of H. pylori infection and colorectal cancer. Therefore, strict colonoscopy screening and surveillance are necessary for patients with H. pylori infection, especially for those with H. pylori-related AG.