Lu Depeng, Wang Mingyu, Ke Xiquan, Wang Qiangwu, Wang Jianchao, Li Dapeng, Wang Meng, Wang Qizhi
Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Front Med (Lausanne). 2022 Jan 18;8:706036. doi: 10.3389/fmed.2021.706036. eCollection 2021.
It has been suggested that () infection is associated with hypergastrinemia and proliferation of colorectal mucosa via direct stimulation, dysbiosis of the gut microbiome, and changes in the gut microbiome, all of which may lead to the formation of colorectal polyps. However, the consensus remains lacking regarding whether infection is independently associated with colorectal polyps and whether the association differs according to histological type of colorectal polyps. To summarize the current evidence regarding the relationship between infection and colorectal polyps, we conducted a meta-analysis of related observational studies according to the histological types of colorectal polyps.
Observational studies investigating the association between infection and colorectal polyps using multivariate analyses were included by search of PubMed, Embase, and Web of Science. A random-effects model was adopted to combine the results.
Seventeen studies that include 322,395 participants were analyzed. It was shown that infection was independently associated with overall colorectal polyps (odds ratio [OR]: 1.67, 95% CI: 1.24-2.24, < 0.001; = 73%). According to the histological type of colorectal polyps, infection was independently associated with adenomatous polyps (APs; OR: 1.71, 95% CI: 1.47-1.99, < 0.001; = 86%), advanced APs (OR: 2.06, 95% CI: 1.56-2.73, < 0.001; = 0%), and hyperplastic polyps (HPs; OR: 1.54, 95% CI: 1.02-2.30, = 0.04; = 78%). Evidence based on only one study showed that infection was not associated with sessile serrated polyps (SSPs; OR: 1.00, 95% CI: 0.93-1.07, = 0.99).
Current evidence from case-control and cross-sectional studies suggested that infection was independently associated with colorectal APs, advanced APs, and HPs, but not with SSPs. These findings suggested infection may be a possible risk factor of colorectal polyp, which is important for the prevention of colorectal polyp in the adult population.
有人提出，（）感染通过直接刺激、肠道微生物群失调和肠道微生物群变化与高胃泌素血症及结肠直肠黏膜增殖有关，所有这些都可能导致结肠直肠息肉的形成。然而，关于（）感染是否与结肠直肠息肉独立相关以及这种关联是否因结肠直肠息肉的组织学类型而异，目前仍缺乏共识。为了总结有关（）感染与结肠直肠息肉之间关系的现有证据，我们根据结肠直肠息肉的组织学类型对相关观察性研究进行了荟萃分析。
通过检索PubMed、Embase和Web of Science纳入使用多变量分析研究（）感染与结肠直肠息肉之间关联的观察性研究。采用随机效应模型合并结果。
分析了17项研究，共322395名参与者。结果显示，（）感染与总体结肠直肠息肉独立相关（优势比[OR]：1.67，95%置信区间：1.24 - 2.24，P < 0.001；I² = 73%）。根据结肠直肠息肉的组织学类型，（）感染与腺瘤性息肉（APs；OR：1.71，95%置信区间：1.47 - 1.99，P < 0.001；I² = 86%）、高级别APs（OR：2.06，95%置信区间：1.56 - 2.73，P < 0.001；I² = 0%）和增生性息肉（HPs；OR：1.54，95%置信区间：1.02 - 2.30，P = 0.04；I² = 78%）独立相关。仅一项研究的证据表明，（）感染与无蒂锯齿状息肉（SSPs；OR：1.00，95%置信区间：0.93 - 1.07，P = 0.99）无关。
病例对照研究和横断面研究的当前证据表明，（）感染与结肠直肠APs、高级别APs和HPs独立相关，但与SSPs无关。这些发现表明，（）感染可能是结肠直肠息肉的一个潜在危险因素，这对成年人群结肠直肠息肉的预防具有重要意义。
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