Correlation between
Helicobacter pylori infection and recurrence of colorectal adenoma.
Shijie Huaren Xiaohua Zazhi 2021;
29:952-959. [DOI:
10.11569/wcjd.v29.i16.952]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND
Colorectal adenoma (CRA) is a precancerous lesion of colorectal cancer. Early resection and prevention of its recurrence are effective measures to prevent the development of colorectal cancer. However, CRA is prone to relapse after removal. Some studies have shown that Helicobacter pylori (H. pylori) infection is one of the causes of CRA. This study aimed to analyze the influence of H. pylori infection and H. pylori eradication on CRA recurrence.
AIM
To investigate the risk factors for recurrence of CRA after surgery, especially the effect of H. pylori infection on the recurrence of CRA.
METHODS
Both outpatients and inpatients with CRA confirmed by colonoscopy and pathology were collected at our hospital, and they were divided into either group A (H. pylori negative group) or B (H. pylori positive group) according to the results of 13C-urea breath test (13C-UBT). The patients in group B were then randomly divided into two groups: C (H. pylori eradicated) and D (H. pylori non-eradicated). One year after polypectomy, the patients were reexamined by colonoscopy and 13C-urea breath test. According to the results of follow-up colonoscopy, the general data of patients with and without recurrence were compared, and the risk factors for CRA recurrence were analyzed by Logistic regression.
RESULTS
A total of 733 patients with colonic adenomatous polyps were enrolled in this study. There were no significant differences in patients' general information, preoperative polyp size, polyp number, pathological type, or surgical method among the groups (P > 0.05). One year after polypectomy, the recurrence rate of polyps in group B was significantly higher than that in group A (23.02% vs 15.79%, P < 0.05), and the recurrence rate of polyps in group C was significantly lower than that in group D (17.37% vs 28.36%, P < 0.05). Male gender, body mass index ≥ 25 kg/m2, the number of colonic polyps ≥ 3, the size of colonic polyp ≥ 20 mm, and H. pylori infection were identified to be risk factors for recurrent colonic polyps (P < 0.05). Logistic regression analysis showed that H. pylori infection was an independent risk factor for recurrent colonic polyps (odds ratio [OR] = 1.556, P < 0.05), while H. pylori eradication was negatively correlated with the recurrence of colonic polyps (OR = 0.509, P < 0.05).
CONCLUSION
H. pylori infection may increase the risk of recurrence of adenomatous colonic polyps, and H. pylori eradication can reduce their recurrence.
Collapse