Department of Internal Medicine, Hanoi Medical University, Hanoi, Vietnam.
Institute of Gastroenterology and Hepatology, Hanoi, Vietnam.
Asian Pac J Cancer Prev. 2020 Aug 1;21(8):2431-2437. doi: 10.31557/APJCP.2020.21.8.2431.
H. pylori infection may play a role in the development of colorectal cancers (CRC). We aimed to examine the association between H. pylori infection and the risk of CRC by anatomical locations.
We conducted a case-control study on 91 incidence cases of CRC and 224 hospital controls. CRC was determined by histopathological examinations. H. pylori IgG antibody in serum was tested. We collected data on the diet, nutrition, and lifestyle by the validated semi-quantitative food frequency and demographic lifestyle questionnaire. The odds ratio and 95% confidence interval (OR (95%CI) were estimated for CRC and its subgroups.
Overall 54.95% of CRC cases and 42.41% of the controls were H. pylori-seropositive, OR (95%CI): 1.56 (0.88, 2.74), p for trend=0.115. Positive dose-response association in quartiles, highest vs lowest, was observed for total CRC, OR (95%CI): 2.14 (1.00, 4.58), p for trend=0.049, for proximal colon, OR (95%CI): 1.52 (0.37, 6.25), p for trend=0.571), and for distal colon and rectum cancers combined, OR (95%CI): 2.38 (1.03, 5.50), p for trend=0.039.
There is a positive association between H. pylori and colorectal cancers, especially distal colon and rectum cancers combined, but additional research is needed to determine the underlying mechanism of chronic H. pylori infection-induced CRC in humans.
幽门螺杆菌(H. pylori)感染可能在结直肠癌(CRC)的发展中起作用。我们旨在通过解剖部位检查 H. pylori 感染与 CRC 风险之间的关联。
我们对 91 例 CRC 发病病例和 224 例医院对照进行了病例对照研究。CRC 通过组织病理学检查确定。检测血清中的 H. pylori IgG 抗体。我们通过经过验证的半定量食物频率和人口统计学生活方式问卷收集饮食、营养和生活方式的数据。估计 CRC 及其亚组的比值比和 95%置信区间(OR(95%CI)。
总体而言,CRC 病例中有 54.95%和对照组中有 42.41%为 H. pylori 血清阳性,OR(95%CI):1.56(0.88,2.74),趋势检验 p 值=0.115。在四分位数中观察到阳性剂量反应关联,最高与最低相比,总 CRC 的 OR(95%CI):2.14(1.00,4.58),趋势检验 p 值=0.049,近端结肠的 OR(95%CI):1.52(0.37,6.25),趋势检验 p 值=0.571),以及远端结肠和直肠癌的组合,OR(95%CI):2.38(1.03,5.50),趋势检验 p 值=0.039。
H. pylori 与结直肠癌之间存在正相关,尤其是远端结肠和直肠癌的组合,但需要进一步研究以确定人类慢性 H. pylori 感染诱导 CRC 的潜在机制。