Effects of Helicobacter pylori infection in gastrointestinal tract malignant diseases: From the oral cavity to rectum

Table 1 Association with Helicobacter pylori infection and oral squamous cell carcinoma

	Prevalence of H. pylori	Diagnostic tool of H. pylori	Study design	P value
Fernando et al[13]	Betel Chewers (20/104; 19.2%) and non-betel chewers (4/69; 5.8%)	Serology	Case- control study	< 0.05
Grandis et al[14]	Case 57% vs controls 62%	Serology	Case- control study	> 0.05
Dayama et al [15]	OR: 3.0; 95%CI: 0.34-26.4	Serum and tissue samples (PCR and culture)	Case- control study	NA
Gupta et al[16]	OR: 2.29; 95%CI: 0.61-8.68	Serology, PCR, culture	Meta-analysis	NA
Meng et al[17]	Case 35.3% vs controls 54.8%	Serology, PCR, histochemical staining	Case- control study	0.012

H. pylori: Helicobacter pylori; OR: Odds ratio; CI: Confidence interval; PCR: Polymerase chain reaction; NA: Not available.

Table 2 Helicobacter pylori infection effect in whole gastroenterology tract malignant diseases

Site	Malignant cell type	H. pylori effect	Odds ratio	95%CI	P value	Gastrointestinal transit time
Oral cavity	Squamous cell carcinoma	Non related				1 min
Pharynx-larynx	Squamous cell carcinoma	Increased risk1	2.87	1.71-4.84	< 0.05	1 s
Oesophagus	Squamous cell carcinoma	Non related				4-8 s
	Adenocarcinoma	Protected effect	0.56	0.46-0.68	< 0.05
Stomach	Adenocarcinoma	Cause-effect	5.9	3.4-10.3	< 0.05	2-4 h
	MALT lymphoma	Cause-effect	1.96	1.0-3.9	< 0.05
Small intestine	Lymphoma	Non related				6 h
Colorectum	Adenocarcinoma	Partial cause-effect	1.7	1.64-1.76	< 0.05	10 h to days
	Lymphoma	Non related

¹Influence of smoking and alcohol consumption on Helicobacter pylori and laryngeal carcinoma was not removed from their study. CI: Confidence interval; MALT: Mucosa-associated lymphoid tissue; H. pylori: Helicobacter pylori.

Table 3 Association with Helicobacter pylori infection and pharyngeal-laryngeal cancer

	Prevalence of H. pylori	Diagnostic tool of H. pylori	Study design	P value
Zhou et al[30]	Laryngeal CA: OR: 3.28; 95%CI: 1.91-5.63	Histochemical, PCR, rapid urease test	Meta-analysis	< 0.0001
	Pharyngeal CA: OR: 1.35; 95%CI: 0.86-2.12			= 0.188
Siupsinskiene et al[31]	Laryngeal CA: Case 46.2% and controls 9.1%	Rapid urease test	Case- control study	< 0.05
Zhou et al[32]	Laryngeal CA: OR: 2.3 95%CI: 1.28-3.23	Serology, histopathological methods	Meta-analysis	< 0.01
Pirzadeh et al[34]	Laryngeal CA: Case 49.2% and controls 40%	Rapid urease test	Case- control study	NA

OR: Odds ratio; CI: Confidence interval; PCR: Polymerase chain reaction; H. pylori: Helicobacter pylori; CA: Cancer; NA: Not available.

Table 4 Association with Helicobacter pylori infection and Esophageal cancer

	Prevalence of H. pylori	Diagnostic tool of H. pylori	Study design	P value
Rokkas et al[44]	EAC: 0.52 (95%CI: 0.37-0.73)	Serology and/or histology	Meta-analysis	EAC: P < 0.001
	ESCC: 0.85 (95%CI: 0.55-1.33)			ESCC: P = 0.48
Islami et al[45]	EAC: 0.56 (95%CI: 0.46-0.68)	Serology and/or histology	Meta-analysis	NA
	ESCC: 1.10 (95%CI: 0.78-1.55)
Nie et al[46]	EAC: 0.57 (95%CI: 0.44-0.73)	Serology and/or histology; rapid urease test	Meta-analysis	NA
	ESCC:1.16 (95%CI: 0.8.-1.60)
Xie et al[47]	EAC: 0.59 (95%CI: 0.51-0.68)	Serology and/or histology; rapid urease test	Meta-analysis	NA
	ESCC: 0.97 (95%CI: 0.76-1.24)
	ESCC in Eastern: 0.66 (95%CI: 0.43-0.89)

CI: Confidence interval; H. pylori: Helicobacter pylori; EAC: Esophageal adenocarcinoma; ESCC: Esophageal squamous-cell carcinoma; NA: Not available.

Table 5 Association with Helicobacter pylori infection and gastric cancer

	Prevalence of H. pylori	Diagnostic tool of H. pylori	Study design	P value
Helicobacter and Cancer Collaborative Group[68]	Non-cardia GC: OR: 5.9; 95%CI: 3.4-10.3	Serology and/or histology	Meta-analysis	P = 0.002
Huang et al[66]	For cagA-positive OR: 1.64; 95%CI: 1.21-2.241	Serology and/or histology	Meta-analysis	NA
Gastric cancer incidence decreased after H. pylori eradication
Lee et al[70]	Incidence rate ratio = 0.53; 95%CI: 0.44-0.64	Serology and/or histology; rapid urease test	Meta-analysis	NA
Chiang et al[71]	Reducing GC incidence of 0.53; 95%CI :0.3-0.69	Rapid urease test	Prospective study	P < 0.001

¹In Helicobacter pylori-infected populations, cagA-positive strains further increased the risk for gastric cancer by 1.64-fold. GC: Gastric cancer; OR: Odds ratio; CI: Confidence interval; H. pylori: Helicobacter pylori; NA: Not available.

Table 6 Association with Helicobacter pylori infection and gastrointestinal tract lymphoma

	Prevalence of H. pylori	Diagnostic tool for H. pylori	Study design	P value
Parsonnet et al[95] (Gastric NHL)	OR: 6.3; 95%CI: 2.0-19.9	Serology	Case- control study	NA
Ishikura et al[97] (Gastric lymphoma overall)	OR: 2.14; 95%CI: 1.3-3.5	Serology	Case- control study	P = 0.003
Ishikura et al[97] (Gastric MALT)	OR: 1.96; 95%CI: 1.0-3.9	Serology	Case- control study	P = 0.051
Ishikura et al[97] (Gastric DLBCL)	OR: 1.92; 95%CI: 0.74-4.95	Serology	Case- control study	P = 0.178
Parsonnet et al[95] (Non-gastric NHL)	OR: 1.2; 95%CI: 0.5-3.0	Serology	Case- control study	NA

NHL: Non-Hodgkin’s lymphomas; MALT: Mucosa-associated lymphoid tissue; DLBCL: Diffuse large B-cell lymphoma; OR: Odds ratio; CI: Confidence interval; H. pylori: Helicobacter pylori; NA: Not available.

Table 7 Association with Helicobacter pylori infection and colorectal adenoma/ cancer

	Prevalence of H. pylori	Diagnostic tool of H. pylori	Study design	P value
Hu et al[113]	OR: 1.44; 95%CI: 1.2-1.73	Rapid urease test	Retrospective	P < 0.001
Sonnenberg et al[122]	OR: 1.52; 95%CI: 1.46-1.57	Histology	Retrospective	NA
Liou et al[124]	Case 14.2% vs controls 11.8%	13C-UBT	Case-control study	P = 0.513
Choi et al[126]	OR: 1.49; 95%CI: 1.37-1.62	Serology, histology, rapid urease test and 13C-UBT	Meta-analysis	P < 0.001
Zuo et al[127]1	OR: 1.70; 95%CI: 1.64-1.76	Serology, histology and rapid urease test	Meta-analysis	NA
Colorectal adenoma incidence decreased after H. pylori eradication
Hu et al[133]2	HR: 3.04; 95%CI: 1.754-5.280	Rapid urease test	Retrospective cohort	P < 0.001

¹For colorectal cancer.

²Second rapid urease test (+) vs (-). ¹³C-UBT: ¹³C-urea breath test; OR: Odds ratio; CI: Confidence interval; H. pylori: Helicobacter pylori; HR: Hazard ratio; NA: Not available.