Yan Y, Chen YN, Zhao Q, Chen C, Lin CJ, Jin Y, Pan S, Wu JS. Helicobacter pylori infection with intestinal metaplasia: An independent risk factor for colorectal adenomas. World J Gastroenterol 2017; 23(8): 1443-1449 [PMID: 28293091 DOI: 10.3748/wjg.v23.i8.1443]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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/
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 Processing time: 134 Days and 22.1 Hours
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.
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.
