Predictive factors and model validation of post-colon polyp surgery Helicobacter pylori infection

ARTICLE HIGHLIGHTS

Research background

Colon polyps are tumor-like lesions that grow on the surface of the colonic mucosa, usually in the form of a protruding or bulging mass, or meaty lesion. They are abnormal tissue that can develop into colorectal cancer. Considering that the number of patients with colon polyps in our country has been rising and that a large number of Helicobacter pylori (H. pylori) infections also exist, an in-depth understanding of the current status of H. pylori infections in patients with colonic polyps in our country and the risk factors for these infections is necessary.

Research motivation

The development of colon tumors is significantly associated with H. pylori infection, of which colonic adenomatous polyps may develop into colon cancer. It is also a risk factor for the development of colonic adenomas, especially progressive or multiple adenomas. However, few clinical studies have investigated the correlation between the pathological types of colonic polyps and H. pylori infection.

Research objectives

To investigate the risk factors for the development of H. pylori infection after colon polyp surgery, and to establish the relationship between the type of pathology and its occurrence.

Research methods

Eighty patients who underwent colon polypectomy in our hospital from January 2019 to January 2023 were retrospectively selected as participants, and randomly divided into a modeling cohort (n = 56) and a model validation cohort (n = 24) at a ratio of 7:3 using R. Simultaneously, based on whether the patients were infected with H. pylori, the modeling cohort was divided into an H. pylori-infected group (n = 37) and an H. pylori-uninfected group (n = 19). The risk factors for H. pylori after colon polyp surgery were analyzed by comparing the age, sex, body mass index (BMI), and exercise status of patients in the modeling cohort (H. pylori-infected and H. pylori-uninfected groups). In addition, whether or not they smoked, consumed alcohol, suffered from hypertension and diabetes mellitus, and had heavy diets, and the number, size, location, and the pathological type of the polyps, and whether or not they were high-risk adenomas, were also analyzed. A 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 therefore established and validated; receiver operating characteristic was used to evaluate the predictive efficacy of the model; calibration curves were used to assess the consistency between predicted and actual events. DCA curves were also used to evaluate the validity of the model; and finally, the correlation between the different pathological types of colon polyps and the occurrence of H. pylori infection was analyzed after colon polyp surgery.

Research results

Age, BMI, and polyp pathology type were independent predictors of H. pylori infection after intestinal polypectomy. Additionally, the H. pylori infection risk column-line diagram model obtained in this study demonstrated good predictive and calibration abilities for both in-sample and out-of-sample validations. The visualized form of the column-line diagram showed that for age ≤ 50 years, the lower the education level, the higher the risk of H. pylori infection after intestinal polypectomy, the higher the BMI, the higher the risk of H. pylori infection, and that patients with adenomatous polyps often have H. pylori infection. This is conducive to the effective clinical discrimination of patients at high risk of H. pylori infection, after intestinal polypectomy, based on the information of the above mentioned key factors. Moreover, the predictors obtained in this study are favorable for the early prevention of H. pylori infection.

Research conclusions

Age, BMI, and polyp pathology of the adenomatous type were all independent predictors of H. pylori infection after intestinal polypectomy, and the column-line graph prediction model of H. pylori infection after intestinal polypectomy showed good predictive ability. This provides assistance in the clinical identification of high-risk groups for H. pylori infection after intestinal polypectomy and is conducive to timely prevention.

Research perspectives

This study was a retrospective analysis with a limited sample size, and additional clinical indicators need to be added for further comprehensive assessment and predictive modeling.