Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2020; 26(37): 5682-5692
Published online Oct 7, 2020. doi: 10.3748/wjg.v26.i37.5682
Helicobacter pylori infection with atrophic gastritis: An independent risk factor for colorectal adenomas
Qin-Fen Chen, Xiao-Dong Zhou, Dan-Hong Fang, En-Guang Zhang, Chun-Jing Lin, Xiao-Zhen Feng, Na Wang, Jian-Sheng Wu, Dan Wang, Wei-Hong Lin
Qin-Fen Chen, Dan-Hong Fang, En-Guang Zhang, Chun-Jing Lin, Xiao-Zhen Feng, Na Wang, Jian-Sheng Wu, Dan Wang, Wei-Hong Lin, Department of Physical Examination Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Xiao-Dong Zhou, Department of Cardiovascular Medicine, The Key Laboratory of Cardiovascular Diseases of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China
Author contributions: Chen QF and Zhou XD contributed equally to this work; Chen QF, Zhou XD, Lin WH, Wang D and Wu JS designed the study; Chen QF, Zhou XD, Feng XZ and Wang N collected data; Chen QF, Zhou XD and Fang DH did the statistical analyses; Chen QF, Zhou XD, Zhang EG and Lin CJ reviewed the results, interpreted data and wrote the manuscript; Lin WH and Wang D are both corresponding authors; All authors have made an intellectual contribution to the manuscript and approved the submission.
Institutional review board statement: The investigation conforms to the principles outlined in the Declaration of Helsinki. The study was approved by the ethical committee of The First Affiliated Hospital of Wenzhou Medical University Ethical Committee.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to examination by verbal consent. Individuals can’t be identified according to the data presented.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Wei-Hong Lin, MD, Nurse, Department of Physical Examination Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Lane, Wenzhou 325000, Zhejiang Province, China. linweihong@wmu.edu.cn
Received: April 21, 2020
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

The aim was to investigate the relationship between colorectal adenomas and H. pylori-related AG based on the histologic diagnosis.

Research methods

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.

Research results

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).

Research conclusions

Our research demonstrated that H. pylori-related AG is an independent risk factor for colorectal adenomas in the Chinese population.

Research perspectives

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.