Siddheshwar R K, Muhammad K B, Gray J C, Kelly S B
Department of Surgery, Regional School of Medicine, North Tyneside General Hospital, Tyne & Wear, North Shields, England.
Am J Gastroenterol. 2001 Jan;96(1):84-8. doi: 10.1111/j.1572-0241.2001.03355.x.
The role of Helicobacter pylori in the pathogenesis of colorectal polyps and colorectal carcinoma is unknown. H. pylori infection causes fasting and meal stimulated hypergastrinemia. Gastrin increases colorectal mucosal proliferation and promotes tumor growth. We performed a prospective study to determine the seroprevalence of H. pylori in patients with colorectal polyps and colorectal carcinoma and in controls.
Blood samples were collected from 189 patients with colorectal carcinoma, 57 patients with colorectal polyps, and 179 controls. H. pylori serology was determined by an ELISA assay.
Logistic regression showed no difference in seroprevalence of H. pylori between patients with colorectal cancer and controls (odds ratio, 1.1; 95% confidence interval, 0.7 to 1.8) or between patients with colorectal polyps and controls (odds ratio 1.3; 95% confidence interval, 0.7 to 2.5). Age and sex were not found to be associated with H. pylori infection. Patients in social classes IV and V were 2.3 times more likely to have H. pylori infection than those in social classes I, II, and III (95% confidence interval, 1.3 to 4.2).
This study shows that there is no increase in the seroprevalence of H. pylori in patients with colorectal polyps or colorectal carcinoma compared with controls. These results do not support the hypothesis that there is a relationship between H. pylori infection and the development of colorectal neoplasia.
幽门螺杆菌在结直肠息肉和结直肠癌发病机制中的作用尚不清楚。幽门螺杆菌感染会导致空腹和进食刺激后的高胃泌素血症。胃泌素会增加结直肠黏膜增殖并促进肿瘤生长。我们进行了一项前瞻性研究,以确定结直肠息肉患者、结直肠癌患者及对照组中幽门螺杆菌的血清流行率。
采集了189例结直肠癌患者、57例结直肠息肉患者和179例对照者的血样。通过酶联免疫吸附测定法检测幽门螺杆菌血清学。
逻辑回归分析显示,结直肠癌患者与对照组之间幽门螺杆菌的血清流行率无差异(比值比为1.1;95%置信区间为0.7至1.8),结直肠息肉患者与对照组之间也无差异(比值比为1.3;95%置信区间为0.7至2.5)。未发现年龄和性别与幽门螺杆菌感染有关。社会阶层为IV和V的患者感染幽门螺杆菌的可能性是社会阶层为I、II和III患者的2.3倍(95%置信区间为1.3至4.2)。
本研究表明,与对照组相比,结直肠息肉患者或结直肠癌患者中幽门螺杆菌的血清流行率并未升高。这些结果不支持幽门螺杆菌感染与结直肠肿瘤发生之间存在关联的假说。