Shmuely Haim, Melzer Ehud, Braverman Michal, Domniz Noam, Yahav Jacob
Department of Internal Medicine D, Kaplan Medical Center, Rehovot and the Faculty of Medicine, Hebrew University , Jerusalem , Israel.
Scand J Gastroenterol. 2014 Jan;49(1):35-42. doi: 10.3109/00365521.2013.848468. Epub 2013 Oct 28.
The aim of this article was to evaluate the prevalence of Helicobacter pylori infection in patients diagnosed with advanced colorectal neoplasia undergoing a colonoscopy compared to patients without neoplasia.
This cross-sectional study investigated the association of neoplastic lesions diagnosed on colonoscopy with H. pylori infection in a consecutive series of subjects who had undergone a pancolonoscopy in a single academic medical center. All patients were tested by ELISA and the immunoblot technique for serum anti-H. pylori and CagA protein IgG antibodies. Multivariate analyses were adjusted for potential-relevant confounders, including age, sex, smoking, childhood socioeconomic status, and family history of colorectal cancer.
Two hundred and seventy-three patients were included in the study: 75% (84/112), diagnosed with neoplastic colorectal lesions and 48% (77/161) without neoplastic lesions, were found to be seropositive for H. pylori infection (p < 0.001). H. pylori infection was found in 66/77 (86 %) patients with advanced neoplasia, 18/35 (51%) patients with nonadvanced neoplasia, and 48% (77/161) patients without neoplasia (p < 0.001). In the adjusted analysis, H. pylori infection was found to be associated with advanced colorectal neoplasia (odds ratio, OR 9.57; 95% CI 4.31-21.2; p < 0.001) and CRC (OR 7.98;95% CI 3.16-20.16; p < 0.001). There was no association in patients who were CagA positive.
H. pylori infection is associated with the development of advanced colorectal neoplasia. More studies are needed to confirm our findings.
本文旨在评估与未患肿瘤的患者相比，接受结肠镜检查的晚期结直肠肿瘤患者中幽门螺杆菌感染的患病率。
这项横断面研究调查了在单一学术医疗中心接受全结肠镜检查的一系列连续受试者中，结肠镜检查诊断出的肿瘤性病变与幽门螺杆菌感染之间的关联。所有患者均通过酶联免疫吸附测定（ELISA）和免疫印迹技术检测血清抗幽门螺杆菌和细胞毒素相关蛋白A（CagA）蛋白IgG抗体。多变量分析针对潜在相关混杂因素进行了调整，包括年龄、性别、吸烟、儿童期社会经济状况和结直肠癌家族史。
273名患者纳入本研究：诊断为结直肠肿瘤性病变的患者中有75%（84/112）、未患肿瘤性病变的患者中有48%（77/161）幽门螺杆菌感染血清学呈阳性（p<0.001）。在患有晚期肿瘤的66/77（86%）名患者、患有非晚期肿瘤的18/35（51%）名患者和未患肿瘤的48%（77/161）名患者中发现了幽门螺杆菌感染（p<0.001）。在调整分析中，发现幽门螺杆菌感染与晚期结直肠肿瘤（优势比，OR 9.57；95%可信区间4.31 - 21.2；p<0.001）和结直肠癌（OR 7.98；95%可信区间3.16 - 20.16；p<0.001）相关。CagA阳性的患者之间无关联。
幽门螺杆菌感染与晚期结直肠肿瘤的发生相关。需要更多研究来证实我们的发现。
