Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 173-185
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.173
Predictive factors and model validation of post-colon polyp surgery Helicobacter pylori infection
Zheng-Sen Zhang
Zheng-Sen Zhang, Health Management Center, Affiliated Hospital of Shaoxing University (Shaoxing Municipal Hospital), Shaoxing 312000, Zhejiang Province, China
Author contributions: Zhang ZS was responsible for the methodology, investigation, software, data curation, formal analysis, writing the original draft and editing, conceptualization, validation.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Affiliated Hospital of Shaoxing University (Shaoxing Municipal Hospital (NO.2023-072-01).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Sen Zhang, BMed, Doctor, Health Management Center, Affiliated Hospital of Shaoxing University (Shaoxing Municipal Hospital), No. 999 Zhongxing South Road, Yuecheng District, Shaoxing 312000, Zhejiang Province, China. sxzzs02@126.com
Received: November 6, 2023
Peer-review started: November 6, 2023
First decision: November 16, 2023
Revised: December 3, 2023
Accepted: December 20, 2023
Article in press: December 20, 2023
Published online: January 27, 2024
Processing time: 79 Days and 21.2 Hours
Abstract
BACKGROUND

Recently, research has linked Helicobacter pylori (H. pylori) stomach infection to colonic inflammation, mediated by toxin production, potentially impacting colorectal cancer occurrence.

AIM

To investigate the risk factors for post-colon polyp surgery, H. pylori infection, and its correlation with pathologic type.

METHODS

Eighty patients who underwent colon polypectomy in our hospital between January 2019 and January 2023 were retrospectively chosen. They were then randomly split into modeling (n = 56) and model validation (n = 24) sets using R. The modeling cohort was divided into an H. pylori-infected group (n = 37) and an H. pylori-uninfected group (n = 19). Binary logistic regression analysis was used to analyze the factors influencing the occurrence of H. pylori infection after colon polyp surgery. A roadmap prediction model was established and validated. Finally, the correlation between the different pathological types of colon polyps and the occurrence of H. pylori infection was analyzed after colon polyp surgery.

RESULTS

Univariate results showed that age, body mass index (BMI), literacy, alcohol consumption, polyp pathology type, high-risk adenomas, and heavy diet were all influential factors in the development of H. pylori infection after intestinal polypectomy. Binary multifactorial logistic regression analysis showed that age, BMI, and type of polyp pathology were independent predictors of the occurrence of H. pylori infection after intestinal polypectomy. The area under the receiver operating characteristic curve was 0.969 [95% confidence interval (95%CI): 0.928–1.000] and 0.898 (95%CI: 0.773–1.000) in the modeling and validation sets, respectively. The slope of the calibration curve of the graph was close to 1, and the goodness-of-fit test was P > 0.05 in the two sets. The decision analysis curve showed a high rate of return in both sets. The results of the correlation analysis between different pathological types and the occurrence of H. pylori infection after colon polyp surgery showed that hyperplastic polyps, inflammatory polyps, and the occurrence of H. pylori infection were not significantly correlated. In contrast, adenomatous polyps showed a significant positive correlation with the occurrence of H. pylori infection.

CONCLUSION

Age, BMI, and polyps of the adenomatous type were independent predictors of H. pylori infection after intestinal polypectomy. Moreover, the further constructed column-line graph prediction model of H. pylori infection after intestinal polypectomy showed good predictive ability.

Keywords: Colon polyps; Helicobacter pylori; Risk factors; Pathologic type; Columnar graphic modeling

Core Tip:Helicobacter pylori (H. pylori) infection is reportedly a risk factor for the development of colonic adenomas, especially progressive or multiple adenomas. However, few studies have examined the risk factors for H. pylori infection after therapeutic colon polypectomy and the type of polyp pathology associated with its occurrence. This randomized study evaluated the risk factors for the development of H. pylori infections in patients with colon polyps and the relationship between their pathology and the development of H. pylori infections.