幽门螺杆菌感染与结直肠息肉/腺瘤的关系：一项单中心横断面研究。
Association of Helicobacter pylori infection with colorectal polyps/adenomas: A single-center cross-sectional study.
机构信息
Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China; Postgraduate College, Jinzhou Medical University, Jinzhou, China.
Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China.
出版信息
Cancer Epidemiol. 2024 Oct;92:102626. doi: 10.1016/j.canep.2024.102626. Epub 2024 Jul 29.
BACKGROUND
Helicobacter pylori (H. pylori) infection may be associated with colorectal polyps/adenomas, but the current evidence remains controversial.
METHODS
We retrospectively screened the medical records of 655 participants who underwent both colonoscopy and H. pylori test from June 15, 2020 to April 30, 2023. The number, size, location, and pathological type of colorectal polyps/adenomas were compared between H. pylori positive and negative groups. Adjusting for age, gender, smoking, drinking, hypertension, diabetes, fatty liver, body mass index, and inflammatory and metabolic indicators, multivariate logistic regression analyses were performed to evaluate the association of H. pylori infection with the number, size, location, and pathological type of colorectal polyps/adenomas, where no polyp/adenoma was used as reference.
RESULTS
Overall, 508 participants were included, of whom 154 and 354 were divided into H. pylori positive and negative groups, respectively. H. pylori positive group had significantly higher colorectal polyps/adenomas (74.7 % vs. 65.8 %, P=0.048), low-grade adenomas (55.7 % vs. 47.6 %, P=0.026), advanced adenomas (22.6 % vs. 13.3 %, P=0.008), and colorectal polyps/adenomas with sizes of ≥6 mm (61.7 % vs. 48.5 %, P=0.002) and ≥10 mm (25.2 % vs. 14.6 %, P=0.004) than H. pylori negative group. In multivariate logistic regression analyses, H. pylori infection was independently associated with low-grade adenomas (OR=2.677, 95 %CI=1.283-5.587, P=0.009), advanced adenomas (OR=3.017, 95 %CI=1.007-9.036, P=0.049), right-side colon polyps/adenomas (OR=5.553, 95 %CI=1.679-18.360, P=0.005), and colorectal polyps/adenomas with sizes of ≥10 mm (OR=4.436, 95 %CI=1.478-13.310, P=0.008), but not number of colorectal polyps/adenomas.
CONCLUSION
H. pylori infection is associated with increased risk of colorectal polyps/adenomas, especially low-grade adenomas, advanced adenomas, right-side colon polyps/adenomas, and large colorectal polyps/adenomas.
背景
幽门螺杆菌（H. pylori）感染可能与结直肠息肉/腺瘤有关，但目前的证据仍存在争议。
方法
我们回顾性筛选了 2020 年 6 月 15 日至 2023 年 4 月 30 日期间接受结肠镜检查和 H. pylori 检测的 655 名参与者的病历。比较 H. pylori 阳性和阴性组的结直肠息肉/腺瘤数量、大小、位置和病理类型。调整年龄、性别、吸烟、饮酒、高血压、糖尿病、脂肪肝、体重指数以及炎症和代谢指标后，采用多变量逻辑回归分析评估 H. pylori 感染与结直肠息肉/腺瘤数量、大小、位置和病理类型的关系，以无息肉/腺瘤为参考。
结果
总体而言，纳入了 508 名参与者，其中 154 名和 354 名分别分为 H. pylori 阳性和阴性组。H. pylori 阳性组结直肠息肉/腺瘤（74.7% vs. 65.8%，P=0.048）、低级别腺瘤（55.7% vs. 47.6%，P=0.026）、高级别腺瘤（22.6% vs. 13.3%，P=0.008）和大小≥6mm 的结直肠息肉/腺瘤（61.7% vs. 48.5%，P=0.002）以及大小≥10mm 的结直肠息肉/腺瘤（25.2% vs. 14.6%，P=0.004）的比例明显更高。多变量逻辑回归分析显示，H. pylori 感染与低级别腺瘤（OR=2.677，95%CI=1.283-5.587，P=0.009）、高级别腺瘤（OR=3.017，95%CI=1.007-9.036，P=0.049）、右侧结肠息肉/腺瘤（OR=5.553，95%CI=1.679-18.360，P=0.005）和大小≥10mm 的结直肠息肉/腺瘤（OR=4.436，95%CI=1.478-13.310，P=0.008）独立相关，但与结直肠息肉/腺瘤数量无关。
结论
H. pylori 感染与结直肠息肉/腺瘤风险增加相关，尤其是低级别腺瘤、高级别腺瘤、右侧结肠息肉/腺瘤和较大的结直肠息肉/腺瘤。
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