Wan Ziqi, Mi Jiarui, Bai Xiaoyin, Wu Dong, Wong Sunny Hei
Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China.
Department of Radiation Oncology, National Clinical Research Center for Cancer, National Cancer Center, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100029, China.
Infect Agent Cancer. 2025 Aug 29;20(1):61. doi: 10.1186/s13027-025-00686-8.
INTRODUCTION: Helicobacter pylori (HP) is a well-established gastric carcinogen. But it shows inconsistent association with colorectal cancer (CRC) across diverse study populations. METHODS: We investigated participants from the UK biobank. HP-seropositive cases and peptic ulcer diseases (PUDs) were identified. The primary outcome was CRC. We estimated the cumulative incidence using a competing risk model measured by the hazard ratios (HRs) with 95% confidence intervals (CIs) with adjustment. We did a genome-wide interaction analysis to identify genetic variants that modify HP-serology-CRC associations with exploratory gene-based and gene-set analysis. We further did a bidirectional two-sample Mendelian randomization (MR) to investigate the causal relation of gene-proxied PUD on CRC of the European ancestry and of the East Asian ancestry. RESULTS: We included 492,490 participants with a median follow-up of 14.7 years. HP sero-positivity did not significantly increase the incidence of CRC (adjusted HR = 0.76, 95% CI 0.53 - 1.10, p = 0.15). No SNP was identified to be significantly interacted with HP serology to modify CRC risk. The risk of CRC for PUD cases was not significantly different from non-PUD cases after adjusting (adjusted HR = 0.88, 95% CI 0.76 - 1.02, p = 0.09). The gene-proxied PUD causally increased the incidence of colon cancer of the East Asian ancestry (OR = 1.47, 95% CI = 1.00 - 2.15, p = 0.047), not of the European ancestry (OR = 1.03, 95% CI = 0.79 - 1.34, p = 0.82). CONCLUSIONS: Neither seropositivity for HP nor PUD showed a robust increase on the risk of CRC in a 15-year follow-up. The causal relation of PUD on CRC was significant of East Asian ancestry, not of European ancestry.
引言:幽门螺杆菌(HP)是一种已被充分证实的胃癌致癌物。但在不同研究人群中,它与结直肠癌(CRC)的关联并不一致。 方法:我们对英国生物银行的参与者进行了调查。确定了HP血清学阳性病例和消化性溃疡疾病(PUD)。主要结局是结直肠癌。我们使用竞争风险模型估计累积发病率,该模型通过调整后的风险比(HR)及95%置信区间(CI)来衡量。我们进行了全基因组相互作用分析,以通过基于探索性基因和基因集的分析来识别可改变HP血清学与结直肠癌关联的基因变异。我们进一步进行了双向双样本孟德尔随机化(MR),以研究基因代理的PUD与欧洲血统和东亚血统的结直肠癌之间的因果关系。 结果:我们纳入了492490名参与者,中位随访时间为14.7年。HP血清学阳性并未显著增加结直肠癌的发病率(调整后HR = 0.76,95% CI 0.53 - 1.10,p = 0.15)。未发现有单核苷酸多态性(SNP)与HP血清学有显著相互作用以改变结直肠癌风险。调整后,PUD病例的结直肠癌风险与非PUD病例无显著差异(调整后HR = 0.88,95% CI 0.76 - 1.02,p = 0.09)。基因代理的PUD因果性增加了东亚血统人群患结肠癌的发病率(比值比[OR] = 1.47,95% CI = 1.00 - 2.15,p = 0.047),而在欧洲血统人群中未增加(OR = 1.03,95% CI = 0.79 - 1.34,p = 0.82)。 结论:在15年的随访中,HP血清学阳性和PUD均未显著增加结直肠癌风险。PUD与结直肠癌的因果关系在东亚血统人群中显著,而在欧洲血统人群中不显著。
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