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Engelsberger V, Gerhard M, Mejías-Luque R. Effects of Helicobacter pylori infection on intestinal microbiota, immunity and colorectal cancer risk. Front Cell Infect Microbiol 2024; 14:1339750. [PMID: 38343887 PMCID: PMC10853882 DOI: 10.3389/fcimb.2024.1339750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024] Open
Abstract
Infecting about half of the world´s population, Helicobacter pylori is one of the most prevalent bacterial infections worldwide and the strongest known risk factor for gastric cancer. Although H. pylori colonizes exclusively the gastric epithelium, the infection has also been associated with various extragastric diseases, including colorectal cancer (CRC). Epidemiological studies reported an almost two-fold increased risk for infected individuals to develop CRC, but only recently, direct causal and functional links between the chronic infection and CRC have been revealed. Besides modulating the host intestinal immune response, H. pylori is thought to increase CRC risk by inducing gut microbiota alterations. It is known that H. pylori infection not only impacts the gastric microbiota at the site of infection but also leads to changes in bacterial colonization in the distal large intestine. Considering that the gut microbiome plays a driving role in CRC, H. pylori infection emerges as a key factor responsible for promoting changes in microbiome signatures that could contribute to tumor development. Within this review, we want to focus on the interplay between H. pylori infection, changes in the intestinal microbiota, and intestinal immunity. In addition, the effects of H. pylori antibiotic eradication therapy will be discussed.
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Affiliation(s)
| | | | - Raquel Mejías-Luque
- Institute for Medical Microbiology, Immunology and Hygiene, TUM School of Medicine and Health, Department Preclinical Medicine, Technical University of Munich, Munich, Germany
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Ma L, Guo W, Zeng Z, Yang F, Tang S, Ling Y. Colorectal cancer risk in East Asian patients with Helicobacter pylori infection: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33177. [PMID: 36897722 PMCID: PMC9997759 DOI: 10.1097/md.0000000000033177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The aim of this systematic review and meta-analysis was to assess the relationship between H pylori infection and colorectal cancer risk in East Asian patients. METHODS Two researchers independently searched for relevant studies in the PubMed, Cochrane, and Embase databases from inception up to April 2022. A meta-analysis was then performed to calculate pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) using a random effects model. RESULTS Nine studies involving 6355 patients were included. Overall, we observed that H pylori infection was associated with an increased risk of colorectal cancer in East Asian patients (OR = 1.48, 95% CI: 1.10-1.99, I2 = 70%), although significant heterogeneity was identified among studies. Subgroup analysis revealed that H pylori infection was associated with an increased risk of colorectal cancer in China (OR = 1.58, 95% CI 1.05-2.37, I2 = 81%) but not in Japan and Korea (OR = 1.26, 95% CI 0.93-1.70, I2 = 0%). CONCLUSION This meta-analysis identified a positive association between H pylori infection and colorectal cancer risk in East Asian patients, especially in China.
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Affiliation(s)
- Lijuan Ma
- Shenzhen Traditional Chinese Medicine Anorectal Hospital Futian, Shenzhen, China
| | - Wentao Guo
- Shenzhen Traditional Chinese Medicine Anorectal Hospital Futian, Shenzhen, China
| | - Zhihui Zeng
- Shenzhen Traditional Chinese Medicine Anorectal Hospital Futian, Shenzhen, China
| | - Fei Yang
- Shenzhen Traditional Chinese Medicine Anorectal Hospital Futian, Shenzhen, China
| | - Shufang Tang
- Shenzhen Traditional Chinese Medicine Anorectal Hospital Futian, Shenzhen, China
| | - Yarui Ling
- Shenzhen Traditional Chinese Medicine Anorectal Hospital Futian, Shenzhen, China
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Are Inflammatory Bowel Disease and Colorectal Carcinoma Associated with Helicobacter pylori? A Prospective Study and Meta-analysis. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2022. [DOI: 10.22207/jpam.16.1.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Observational studies regarding the correlation between colorectal carcinoma, inflammatory bowel disease and Helicobacter pylori infection are inconsistent. The present study aims to investigate the association between colorectal adenocarcinoma (CRA) and inflammatory bowel disease (IBD) with H. pylori status in 100 patients who have inflammatory bowel disease and colorectal carcinoma was confirmed disease by histological approach. Besides, a meta-analysis was performed of published studies, to evaluate the link between H. pylori infection and an increased risk of CRC and IBD. Among 67 cases with CRA and 33 cases with IBD, 59.7% and 51.5% were H. pylori positive; respectively. In the meta-analysis, thirty-nine articles were included, involving 13 231 cases with CRC and 2477 with IBD. The pooled odds ratio for CRC and IBD was 1.16 (95%CI = 0.73-1.82) and 0.42 (95%CI = 0.32-0.56); respectively. Our meta-analysis indicates that H. pylori is not associated with CRC.
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Lu D, Wang M, Ke X, Wang Q, Wang J, Li D, Wang M, Wang Q. Association Between H. pylori Infection and Colorectal Polyps: A Meta-Analysis of Observational Studies. Front Med (Lausanne) 2022; 8:706036. [PMID: 35118081 PMCID: PMC8803908 DOI: 10.3389/fmed.2021.706036] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background It has been suggested that Helicobacter pylori (H. pylori) 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 H. pylori 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 H. pylori infection and colorectal polyps, we conducted a meta-analysis of related observational studies according to the histological types of colorectal polyps. Methods Observational studies investigating the association between H. pylori 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. Results Seventeen studies that include 322,395 participants were analyzed. It was shown that H. pylori infection was independently associated with overall colorectal polyps (odds ratio [OR]: 1.67, 95% CI: 1.24–2.24, p < 0.001; I2 = 73%). According to the histological type of colorectal polyps, H. pylori infection was independently associated with adenomatous polyps (APs; OR: 1.71, 95% CI: 1.47–1.99, p < 0.001; I2 = 86%), advanced APs (OR: 2.06, 95% CI: 1.56–2.73, p < 0.001; I2 = 0%), and hyperplastic polyps (HPs; OR: 1.54, 95% CI: 1.02–2.30, p = 0.04; I2 = 78%). Evidence based on only one study showed that H. pylori infection was not associated with sessile serrated polyps (SSPs; OR: 1.00, 95% CI: 0.93–1.07, p = 0.99). Conclusions Current evidence from case-control and cross-sectional studies suggested that H. pylori infection was independently associated with colorectal APs, advanced APs, and HPs, but not with SSPs. These findings suggested H. pylori infection may be a possible risk factor of colorectal polyp, which is important for the prevention of colorectal polyp in the adult population.
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Affiliation(s)
- Depeng Lu
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Mingyu Wang
- Department of Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Xiquan Ke
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qiangwu Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Jianchao Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Dapeng Li
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Meng Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Qizhi Wang
- Department of Gastroenterology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- *Correspondence: Qizhi Wang
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Ko HJ, Lin YC, Chen CC, Chen MJ, Wu MS, Liu CJ, Huang CT, Yang HW, Shih SC, Yu LY, Kuo YC, Wang HY, Hu KC. Helicobacter pylori infection and increased diabetes prevalence were the risks of colorectal adenoma for adults: A systematic review and meta-analysis (PRISMA-compliant article). Medicine (Baltimore) 2021; 100:e28156. [PMID: 34918670 PMCID: PMC8677985 DOI: 10.1097/md.0000000000028156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/18/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Helicobacter pylori infection and hyperglycemia are associated with an increased risk of colorectal neoplasm, and may have a synergistic effect in combination. However, these 2 factors that affect colorectal neoplasm remain controversial. We aimed to carry out a meta-analysis to evaluate the study population diabetes prevalence rate and H pylori infection rate with colorectal adenoma risk for adults. METHODS We conducted systemic research through English databases for medical reports. We also recorded the diabetes prevalence and H pylori infection prevalence in each study. We classified these studies into 4 subgroups as their background population diabetes prevalence <6% (Group 1); between 6% and 8% (Group 2); between 8% and 10% (Group 3), and more than 10% (Group 4). The random-effects model had used to calculate pooled prevalence estimates with 95% confidence interval (CI). RESULTS Twenty-seven studies were finally eligible for meta-analysis. The random-effects model of the meta-analysis was chosen, showing pooled odds ratio (OR) equal to 1.51 (95% CI 1.39-1.63). The subgroup meta-analyses showed in Group 1 the H pylori infection associated colorectal adenoma risk OR was 1.24 (95% CI 0.86-1.78). As the diabetes rate exceed 6%, the H pylori infection became the more significant increased risk of colorectal adenoma (Group 2: OR 2.16 (95% CI 1.61-2.91); Group 3: OR 1.40 (95% CI 1.24-1.57); and Group 4: OR 1.52 (95% CI 1.46-1.57)). CONCLUSIONS The results of this meta-analysis showed elevated diabetes prevalence combined H pylori infection increasing the risks of colorectal adenoma in the adult population.
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Affiliation(s)
- Hung-Ju Ko
- Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Ying-Chun Lin
- Department of Anesthesia, MacKay Memorial Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University
| | - Chieh-Chang Chen
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Jen Chen
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan Healthy
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chun-Jen Liu
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chun-Ta Huang
- Division of Endocrine, Department of Internal Medicine, DM Center, MacKay Memorial Hospital, Taipei, Taiwan
| | - Horng-Woei Yang
- Departments of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shou-Chuan Shih
- Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan Healthy
- MacKay Medical College, Taipei, Taiwan
| | - Lo-Yip Yu
- Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan Healthy
| | - Yang-Che Kuo
- Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan Healthy
| | - Horng-Yuan Wang
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan Healthy
| | - Kuang-Chun Hu
- Healthy Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan Healthy
- MacKay Medical College, Taipei, Taiwan
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Zuo Y, Jing Z, Bie M, Xu C, Hao X, Wang B. Association between Helicobacter pylori infection and the risk of colorectal cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21832. [PMID: 32925719 PMCID: PMC7489651 DOI: 10.1097/md.0000000000021832] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The existing evidence on the relationship between Helicobacter pylori infection and the risk of colorectal cancer is inconsistent. We conducted a systematic review with a meta-analysis to explore this relationship and to determine whether the relationship varies according to the study characteristics. METHODS We searched the PubMed, OVID, EMBASE database, and the reference lists of pertinent articles published up to October 2019 by 2 researchers independently. Summary odds ratios (OR) with their 95% confidence intervals (CIs) were estimated using a random-effects model. RESULTS Forty seven studies including 17,416 cases of colorectal cancer (CRC) and 55,811 cases of control were included. Overall, H. pylori infection was associated with an increased risk of CRC (OR = 1.70 95% CI 1.64-1.76, I = 97%), although there was significant heterogeneity among the studies. Subgroup analysis revealed that the positive correlation might vary by the design of study conducted. CONCLUSION This meta-analysis demonstrates a positive association between H. pylori infection and the risk of colorectal cancer.
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Affiliation(s)
- Yuling Zuo
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Zhao Jing
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Mingjiang Bie
- West China fourth hospital of Public Health, Sichuan University
| | - Chunyan Xu
- J. N. Medical Laboratory, Big Data Research Center, University of Electronic Science and Technology of China
| | - Xinyu Hao
- College of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Sichuan
| | - Baoning Wang
- West China School of Basic medical sciences and Forensic Medicine, Sichuan University, Chengdu, China
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Risk for Colorectal Neoplasia in Patients With Helicobacter pylori Infection: A Systematic Review and Meta-analysis. Clin Transl Gastroenterol 2020; 11:e00127. [PMID: 32032128 PMCID: PMC7145030 DOI: 10.14309/ctg.0000000000000127] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori may reportedly be associated with extragastric malignancy beyond gastric cancer. The present study aimed to evaluate the association between H. pylori infection and colorectal neoplasia through a systematic review and meta-analysis.
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Yang F, Xu YL, Zhu RF. Helicobacter pylori infection and the risk of colorectal carcinoma: a systematic review and meta-analysis. Minerva Med 2019; 110:464-470. [PMID: 31368293 DOI: 10.23736/s0026-4806.19.05942-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Helicobacter pylori is a gram-negative bacterium that is colonized in the stomach. H. pylori infection can lead to a series of stomach diseases. However, the relationship between H. pylori infection and colorectal cancer is currently controversial. Therefore, we performed this meta-analysis to further understand the relationship between H. pylori infection and colorectal cancer. EVIDENCE ACQUISITION We conducted a comprehensive retrieval from electronic databases, included the PubMed, Medline, China National Knowledge Infrastructure (CNKI), and China Wanfang Data Knowledge Service Platform databases (Wanfang Databases) through May 1st, 2018. We used the search terms H. pylori and colorectal cancer or colorectal carcinoma and collected all relevant studies to explore the association between H. pylori infection and colorectal cancer. EVIDENCE SYNTHESIS Twenty-seven studies including 14357 cases were included. H. pylori infection was associated with an increased risk of colorectal cancer. A pooled odds ratio (OR) of 1.27 with a 95% CI of 1.17-1.37 (P<0.001) was calculated by using a fixed-effects model (I2=45.5%, P=0.006). The subgroup analysis revealed that H. pylori infection was associated with an increased risk of colorectal cancer in the subgroups of Western countries (OR=1.34, 95% CI: 1.14-1.57) (P<0.001), serological testing (OR=1.20, 95% CI: 1.08-1.34) (P=0.001), multiple methods of testing (OR=2.63, 95% CI: 1.09-6.31) (P=0.031), cross-sectional studies (OR=1.92, 95% CI: 1.17-3.16) (P=0.010) and case-control studies (OR 1.26, 95% CI: 1.16-1.36) (P<0.001). CONCLUSIONS The present meta-analysis provides evidence suggests that a positive association between H. pylori infection and the risk of colorectal cancer.
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Affiliation(s)
- Fan Yang
- Department of Intensive Care, Sixth People's Hospital of Nantong, Nantong, China
| | - Ying-Lu Xu
- Department of General Surgery, Third People's Hospital of Nantong, Nantong, China
| | - Ren-Fei Zhu
- Department of General Surgery, Third People's Hospital of Nantong, Nantong, China -
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Affiliation(s)
- Julia Butt
- Department of Population Health Sciences, Duke University and Cancer Control and Population Sciences Program, Duke Cancer Institute, Durham, North Carolina, United States of America
| | - Meira Epplein
- Department of Population Health Sciences, Duke University and Cancer Control and Population Sciences Program, Duke Cancer Institute, Durham, North Carolina, United States of America
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Hu KC, Wu MS, Chu CH, Wang HY, Lin SC, Liu SC, Liu CC, Su TH, Chen CL, Liu CJ, Shih SC. Synergistic Effect of Hyperglycemia and Helicobacterpylori Infection Status on Colorectal Adenoma Risk. J Clin Endocrinol Metab 2017; 102:2744-2750. [PMID: 28475740 DOI: 10.1210/jc.2017-00257] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/01/2017] [Indexed: 02/09/2023]
Abstract
CONTEXT Both Helicobacter pylori and type 2 diabetes mellitus are possible risk factors for colon adenoma. OBJECTIVE The purpose of this study was to assess the interaction between H. pylori and hyperglycemia status on the risk of colon adenoma. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional, retrospective study conducted at the MacKay Memorial Hospital, Taiwan. The study included 3943 subjects aged >40 years undergoing bidirectional gastrointestinal endoscopy on the same day between July 2006 and June 2015. All subjects had a gastric biopsy specimen tested for H. pylori. MAIN OUTCOME MEASURE Colon adenoma with and without H. pylori infection at different hemoglobin A1c (HbA1c) levels. RESULTS The prevalence of colorectal adenomas in patients who were H. pylori-positive and H. pylori-negative was 37.3% and 27.29%, respectively. Multivariate logistic regression analysis identified male sex, age, body mass index, H. pylori infection, and HbA1c ≥6.5% as independent risk factors for adenoma; use of hypoglycemic agents decreased this risk. The prevalence of adenoma was increased with elevated HbA1c levels regardless of H. pylori status. The odds ratio (OR) for adenoma was 1.44 (95% confidence interval [CI], 1.20 to 1.73) if H. pylori was present or 1.68 (95% CI, 1.05 to 2.70) in patients who were H. pylori-negative but had HbA1c ≥7.0%. If both conditions were present, the OR was 4.79 (95% CI, 2.92 to 7.84). A 1% increase in HbA1c was associated with an increased prevalence of adenoma by 42.4% in H. pylori-positive subjects. CONCLUSIONS The combination of H. pylori infection and elevated HbA1c is associated with an increased risk of colon adenoma.
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Affiliation(s)
- Kuang-Chun Hu
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
- Health Evaluation Center, MacKay Memorial Hospital, Taipei 10449, Taiwan
- MacKay Medicine, Nursing and Management College, Taipei 11260, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
- MacKay Medical College, Taipei 25245, Taiwan
| | - Ming-Shiang Wu
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 10051, Taiwan
| | - Cheng-Hsin Chu
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
- MacKay Medicine, Nursing and Management College, Taipei 11260, Taiwan
| | - Horng-Yuan Wang
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
- Health Evaluation Center, MacKay Memorial Hospital, Taipei 10449, Taiwan
- MacKay Medicine, Nursing and Management College, Taipei 11260, Taiwan
| | - Shee-Chan Lin
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
- MacKay Medicine, Nursing and Management College, Taipei 11260, Taiwan
| | - Sung-Chen Liu
- Division of Endocrinology, Department of Internal Medicine, Diabetes Center, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Chuan-Chuan Liu
- Health Evaluation Center, MacKay Memorial Hospital, Taipei 10449, Taiwan
| | - Tung-Hung Su
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 10051, Taiwan
| | - Chi-Ling Chen
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
| | - Chun-Jen Liu
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 10051, Taiwan
| | - Shou-Chuan Shih
- Division of Gastroenterology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei 10449, Taiwan
- Health Evaluation Center, MacKay Memorial Hospital, Taipei 10449, Taiwan
- MacKay Medicine, Nursing and Management College, Taipei 11260, Taiwan
- MacKay Medical College, Taipei 25245, Taiwan
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Helicobacter pylori infection is an independent risk factor for colonic adenomatous neoplasms. Cancer Causes Control 2016; 28:107-115. [PMID: 28025763 DOI: 10.1007/s10552-016-0839-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 12/19/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE Helicobacter pylori infection is considered to have a positive association with colorectal neoplasms. In this study, we evaluated the association between H. pylori infection and colorectal adenomas, based on the characteristics of these adenomas in Korea, where the prevalence of H. pylori infection is high and the incidence of colorectal cancer continues to increase. METHODS The study cohort consisted of 4,466 subjects who underwent colonoscopy and esophagogastroduodenoscopy during screening (1,245 colorectal adenomas vs. 3,221 polyp-free controls). We compared the rate of H. pylori infection between patients with adenoma and polyp-free control cases, using multivariable logistic regression analysis. RESULTS The overall rate of positive H. pylori infection was higher in adenoma cases than in polyp-free control cases (55.0 vs. 48.5%, p < 0.001). The odds ratio (OR) of positive H. pylori infection in patients with adenoma compared to polyp-free controls was 1.28 (95% CI 1.11-1.47). The positive association of H. pylori infection with colorectal adenomas was more prominent in advanced adenomas (OR 1.84, 95% CI 1.25-2.70) and multiple adenomas (OR 1.72, 95% CI 1.26-2.35). Based on the location of these adenomas, the OR was significant only in patients with colonic adenomas (OR 1.31, 95% CI 1.13-1.52) and not in those with rectal adenoma (OR 0.85, 95% CI 0.58-1.24). CONCLUSION Helicobacter pylori infection is an independent risk factor for colonic adenomas, especially in cases of advanced or multiple adenomas, but not for rectal adenomas.
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Clinicopathologic features of gastric cancer with synchronous and metachronous colorectal cancer in Korea: are microsatellite instability and p53 overexpression useful markers for predicting colorectal cancer in gastric cancer patients? Gastric Cancer 2016; 19:798-807. [PMID: 26445944 DOI: 10.1007/s10120-015-0552-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 09/22/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND A large-scale study was performed to identify the risk factors for developing synchronous and metachronous colorectal cancer (CRC) in gastric cancer (GC) patients, including microsatellite instability (MSI) and p53 overexpression. METHODS A total of 1041 GC patients who underwent endoscopic resection or surgery and underwent colonoscopy simultaneously or during surveillance for GC were consecutively enrolled. Clinicopathologic characteristics, MSI, and p53 overexpression were compared between the GC patients with and those without synchronous and metachronous CRC. RESULTS Of the 1041 patients, CRCs were detected in 67 (6.4 %) patients with GC. Forty-six (4.4 %) had synchronous CRC and 21 (2.0 %) had metachronous CRC. Univariate analysis indicated that age ≥63 years (P < 0.001), male sex (P = 0.005), and p53 overexpression (P = 0.040) were significantly associated with a higher incidence of CRC. However, body mass index, smoking, tumor location, tumor multiplicity, tumor histology, TNM stage, and MSI were not significantly associated with the incidence of CRC. Age ≥63 years (OR: 5.881; 95 % CI: 3.083-11.221; P < 0.001) and male sex (OR: 2.933; 95 % CI: 1.307-6.584; P = 0.009) were risk factors for CRC in GC patients according to multivariate analysis. CONCLUSIONS GC patients who are male and/or ≥63 years old are recommended to receive colonoscopy to detect CRC. MSI and p53 overexpression were not useful molecular markers for predicting CRC in GC.
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Combination of Triple Therapy and Chronic PPI Use May Decrease Risk of Colonic Adenomatous Polyps in Helicobacter pylori Infection. Gastroenterol Res Pract 2015; 2015:638547. [PMID: 26064095 PMCID: PMC4443787 DOI: 10.1155/2015/638547] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 04/03/2015] [Indexed: 12/22/2022] Open
Abstract
Aim. The aim of the paper is to determine association between H. pylori and colonic adenomatous polyps and to explore whether treatment or chronic PPI use can mitigate this risk. Methods. This case-control study included 943 patients who had H. pylori testing and underwent colonoscopy. Presence of polyps was the outcome of interest, whereas age, sex, race, H. pylori infection, triple therapy, and chronic PPI use were independent variables. Multivariate regression analysis was used to calculate odds ratios at 95% confidence intervals. This study was approved by the New York Medical College Institutional Review Board. Results. H. pylori was associated with increased odds of colonic adenomatous polyps (adjusted OR 1.43, 95% CI 1.04–1.77), with stronger association among patients older than 50 (OR 1.65, 95% CI 1.18–2.33). Triple therapy (OR 0.69, 95% CI 0.44–1.07) or chronic PPI use (OR 0.69, 95% CI 0.43–1.09) decreased odds of polyp formation. Analysis revealed a statistically significant reduction in patients who received both triple therapy and chronic PPI, lowering the odds by 60% (adjusted OR 0.43, 95% CI 0.27–0.67). Conclusion. There is increased risk of colonic adenomatous polyps among H. pylori-infected patients. Triple therapy or chronic PPI use may mitigate this risk, with further reduction when these two interventions are combined.
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Franceschi F, Tortora A, Gasbarrini G, Gasbarrini A. Helicobacter pylori and extragastric diseases. Helicobacter 2014; 19 Suppl 1:52-8. [PMID: 25167946 DOI: 10.1111/hel.12159] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
While Helicobacter pylori infection was initially revealed to be associated only with some gastroduodenal diseases, further studies have shown its possible role in several extragastric diseases. For idiopathic thrombocytopenic purpura, sideropenic anemia, and vitamin B12 deficiency, the diagnosis of H. pylori infection is recommended, and there are many other conditions such as cardiovascular, neurological, dermatological, and respiratory diseases in which H. pylori may possibly play a role. Interestingly, a potential role has also been described for GI neoplastic diseases, including colorectal and pancreatic cancer. Different mechanisms of action have been proposed, ranging from the induction of a low grade inflammatory state to the occurrence of molecular mimicry mechanisms. This review summarizes the results of the most relevant studies published on this topic over the last year.
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Hagymási K, Tulassay Z. Helicobacter pylori infection: New pathogenetic and clinical aspects. World J Gastroenterol 2014; 20:6386-6399. [PMID: 24914360 PMCID: PMC4047324 DOI: 10.3748/wjg.v20.i21.6386] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 11/02/2013] [Accepted: 02/27/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infects more than half of the world’s human population, but only 1% to 3% of infected people consequently develop gastric adenocarcinomas. The clinical outcome of the infection is determined by host genetic predisposition, bacterial virulence factors, and environmental factors. The association between H. pylori infection and chronic active gastritis, peptic ulcer disease, gastric cell carcinoma, and B cell mucosa-associated lymphoid tissue lymphoma has been well established. With the exception of unexplained iron deficiency anemia and idiopathic thrombocytopenic purpura, H. pylori infection has no proven role in extraintestinal diseases. On the other hand, there is data showing that H. pylori infection could be beneficial for some human diseases. The unpredictability of the long-term consequences of H. pylori infection and the economic challenge in eradicating it is why identification of high-risk individuals is crucial.
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