Kim Tae Jun, Kim Eun Ran, Chang Dong Kyung, Kim Young-Ho, Baek Sun-Young, Kim Kyunga, Hong Sung Noh
Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Helicobacter. 2017 Jun;22(3). doi: 10.1111/hel.12377. Epub 2017 Jan 26.
The role of Helicobacter pylori (H. pylori) in the development of colorectal neoplasm remains controversial. We examined the association between H. pylori infection and colorectal neoplasm in a large sample of healthy participants who underwent screening colonoscopy.
A cross-sectional study of 8916 men, who participated in a regular health-screening examination that included an H. pylori-specific immunoglobulin G antibody test and colonoscopy, was conducted to evaluate the association between H. pylori and colorectal neoplasm.
Multivariable analyses adjusted for age, body mass index, smoking status, alcohol intake, regular exercise, regular aspirin use, and family history of colorectal cancer showed that the odds ratio (OR) (95% confidence interval [CI]) for any adenoma and advanced neoplasm was 1.32 (1.07-1.61) and 1.90 (1.05-3.56) in participants with H. pylori infection and without H. pylori infection, respectively. The association persisted after further adjustment for inflammatory markers or metabolic variables including fasting blood glucose, triglycerides, high-density lipoprotein-cholesterol, and low-density lipoprotein-cholesterol. Regarding the location, a positive association was confined to cases with proximal adenomas and was observed similarly in all the evaluated subgroups.
In a large-scale study, carefully controlled for confounding factors, involving asymptomatic participants without a history of colonoscopy, H. pylori infection was significantly associated with the risk of any colorectal adenoma and advanced colorectal neoplasm. Prospective studies are necessary to determine whether H. pylori eradication can reduce this risk.
幽门螺杆菌（H. pylori）在结直肠肿瘤发生发展中的作用仍存在争议。我们在接受筛查结肠镜检查的大量健康参与者样本中，研究了幽门螺杆菌感染与结直肠肿瘤之间的关联。
对8916名男性进行了一项横断面研究，这些男性参加了包括幽门螺杆菌特异性免疫球蛋白G抗体检测和结肠镜检查在内的常规健康筛查检查，以评估幽门螺杆菌与结直肠肿瘤之间的关联。
在对年龄、体重指数、吸烟状况、饮酒量、规律运动、规律使用阿司匹林以及结直肠癌家族史进行多变量分析后发现，幽门螺杆菌感染组和未感染组中，任何腺瘤和进展期肿瘤的比值比（OR）（95%置信区间[CI]）分别为1.32（1.07 - 1.61）和1.90（1.05 - 3.56）。在进一步调整炎症标志物或代谢变量（包括空腹血糖、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇）后，这种关联仍然存在。就部位而言，正相关仅限于近端腺瘤病例，并且在所有评估亚组中均有类似发现。
在一项精心控制混杂因素、纳入无结肠镜检查史无症状参与者的大规模研究中，幽门螺杆菌感染与任何结直肠腺瘤和进展期结直肠肿瘤的风险显著相关。需要进行前瞻性研究以确定根除幽门螺杆菌是否可以降低这种风险。
