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World J Gastroenterol. Feb 14, 2014; 20(6): 1485-1492
Published online Feb 14, 2014. doi: 10.3748/wjg.v20.i6.1485
Helicobacter pylori-related chronic gastritis as a risk factor for colonic neoplasms
Izumi Inoue, Jun Kato, Hideyuki Tamai, Mikitaka Iguchi, Takao Maekita, Noriko Yoshimura, Masao Ichinose
Izumi Inoue, Jun Kato, Hideyuki Tamai, Mikitaka Iguchi, Takao Maekita, Masao Ichinose, the Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-0012, Japan
Noriko Yoshimura, Department of Joint Disease Research, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo 113-8655, Japan
Author contributions: Inoue I and Ichinose M conceptualized the review; Inoue I performed the analysis of the pertinent literature and wrote the first draft of the manuscript; Yoshimura N contributed data analyses and interpretation; Tamai H, Iguchi M and Maekita T performed the critical revision of the manuscript; Kato J and Ichinose M edited the final draft; all authors approved the final version.
Correspondence to: Izumi Inoue, MD, PhD, the Second Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama City, Wakayama 641-0012, Japan. izumiino@wakayama-med.ac.jp
Telephone: +81-734-472300 Fax: +81-734-453616
Received: October 3, 2013
Revised: November 19, 2013
Accepted: January 3, 2014
Published online: February 14, 2014
Processing time: 136 Days and 16.5 Hours
Abstract

To summarize the current views and insights on associations between Helicobacter pylori (H. pylori)-related chronic gastritis and colorectal neoplasm, we reviewed recent studies to clarify whether H. pylori infection/H. pylori-related chronic gastritis is associated with an elevated risk of colorectal neoplasm. Recent studies based on large databases with careful control for confounding variables have clearly demonstrated an increased risk of colorectal neoplasm associated with H. pylori infection. The correlation between H. pylori-related chronic atrophic gastritis (CAG) and colorectal neoplasm has only been examined in a limited number of studies. A recent large study using a national histopathological database, and our study based on the stage of H. pylori-related chronic gastritis as determined by serum levels of H. pylori antibody titer and pepsinogen, indicated that H. pylori-related CAG confers an increased risk of colorectal neoplasm, and more extensive atrophic gastritis will probably be associated with even higher risk of neoplasm. In addition, our study suggested that the activity of H. pylori-related chronic gastritis is correlated with colorectal neoplasm risk. H. pylori-related chronic gastritis could be involved in an increased risk of colorectal neoplasm that appears to be enhanced by the progression of gastric atrophy and the presence of active inflammation.

Keywords: Colorectal neoplasm; Cancer risk; Pepsinogen; Helicobacter pylori antibody; Atrophic gastritis

Core tip: This review revealed that Helicobacter pylori (H. pylori)-related chronic gastritis plays a role in risk enhancement of colorectal neoplasm, and that this risk could be further enhanced by the progression of atrophy and the presence of active inflammation. These findings may be useful for selecting groups at high risk for colorectal neoplasm that warrant colonoscopic surveillance, particularly in areas where H. pylori infection is highly prevalent.