Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2016; 22(18): 4576-4584
Published online May 14, 2016. doi: 10.3748/wjg.v22.i18.4576
Correlation between Helicobacter pylori-associated gastric diseases and colorectal neoplasia
Ying Qing, Min Wang, Ying-Min Lin, Dong Wu, Jing-Yu Zhu, Lang Gao, Yan-Yan Liu, Teng-Fei Yin
Ying Qing, Min Wang, Lang Gao, Yan-Yan Liu, Teng-Fei Yin, Department of Geriatric Gastroenterology, Qi-Lu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Min Wang, Ying-Min Lin, Department of General Medicine, Qi-Lu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Dong Wu, Department of General Surgery, Qi-Lu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Jing-Yu Zhu, Department of Gastroenterology, Jinan Central Hospital, Jinan 250013, Shandong Province, China
Author contributions: Qing Y designed and performed the research and wrote the paper; Wang M designed the research and supervised the report; Lin YM and Wu D contributed to the data collection and analysis; Zhu JY, Gao L, Liu YY and Yin TF provided clinical advice and contributed to the analysis.
Supported by the National Natural Science Foundation of China, No. 81372681; and Key Research Development Program of Shandong Province, No. 2015GGH318014.
Institutional review board statement: This study was reviewed and approved by the Research and Ethics Committee at Qi-Lu Hospital of Shandong University, China.
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 treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
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: Min Wang, MD, PhD, Associate Professor, Department of Geriatric Gastroenterology, Qi-Lu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan 250012, Shandong Province, China. doctorminmin@163.com
Telephone: +86-531-82166601 Fax: +86-531-82166601
Received: December 25, 2015
Peer-review started: December 25, 2015
First decision: January 28, 2016
Revised: February 11, 2016
Accepted: March 1, 2016
Article in press: March 2, 2016
Published online: May 14, 2016
Processing time: 131 Days and 8.8 Hours
Abstract

AIM: To explore the correlation between Helicobacter pylori (H. pylori)-associated gastric diseases and colorectal neoplasia.

METHODS: Patients included in this study underwent a colonoscopy and esophago-gastro-duodenoscopy (EGD) along with histopathological measurement between March 2012 and March 2015 at Qi-Lu Hospital of Shandong University, who also had results of H. pylori detection. A total of 233 cases were selected. Demographic data, H. pylori infection status (including results of rapid urease tests and gastric mucosa pathological examinations) and histopathological examination results of gastric and colorectal mucosa were gathered and analyzed. The statistical analysis focused on the prevalence of colorectal neoplasms among patients with various histopathological categories of the stomach. ORs and their 95%CI were calculated to describe the strengths of the associations.

RESULTS: The incidence rates of colorectal adenoma without high-grade intraepithelial neoplasia (HGIEN) (OR = 2.400, 95%CI: 0.969-5.941), adenoma with HGIEN (5.333, 1.025-27.758) and adenocarcinoma (1.455, 0.382-5.543) were all higher for patients with H. pylori-associated gastritis than for those in the control group. The incidence rate of colorectal adenoma with HGIEN (3.218, 0.767-13.509) was higher in patients with intestinal metaplasia than in the control group, while the incidence rates of adenoma without HGIEN (0.874, 0.414-1.845) and adenocarcinoma (0.376, 0.096-1.470) were lower in the intestinal metaplasia group than in the control group. The incidence rate of colorectal adenoma without HGIEN (3.111, 1.248-7.753) was significantly higher in the gastric intraepithelial neoplasia group than in the control group, while the rates of adenoma with HGIEN (1.481, 0.138-15.941) and adenocarcinoma (2.020, 0.561-7.272) were higher in the gastric intraepithelial neoplasia group. Incidence rates of colorectal adenoma without HGIEN (1.067, 0.264-4.314), adenoma with HGIEN (2.667, 0.231-30.800) and adenocarcinoma (2.182, 0.450-10.585) were all higher in the gastric adenocarcinoma group than in the control group.

CONCLUSION: H. pylori infection as well as H. pylori-associated gastric diseases are risk factors for colorectal neoplasia.

Keywords: Helicobacter pylori; Helicobacter pylori-associated gastric diseases; Colorectal neoplasia; Endoscopy with pathological biopsy; Chinese population

Core tip: Few studies have investigated the relationship between Helicobacter pylori (H. pylori)-associated gastric diseases and colorectal neoplasia. In particular, no such research on the Chinese population has been reported so far. To explore this correlation in the Chinese population, demographic data, H. pylori infection status and histopathological data of gastric and colorectal mucosa of 233 Chinese patients were gathered and analyzed. The results demonstrated that H. pylori-associated gastric diseases might increase the risk of colorectal neoplasia regardless of the number, size and location of the neoplasm. Therefore, we can assume that H. pylori-associated gastric diseases are potential risk factors for colorectal neoplasia in the Chinese population.