Helicobacter pylori is a Risk Factor for Colonic Neoplasms

1] Portland VA Medical Center, Portland, Oregon, USA [2] Oregon Health and Science University, Portland, Oregon, USA.
The American Journal of Gastroenterology (Impact Factor: 10.76). 12/2012; 108(2). DOI: 10.1038/ajg.2012.407
Source: PubMed


It has been suggested that Helicobacter pylori (H. pylori) constitutes a risk for the development of adenomatous polyps and adenocarcinoma of the colon. Our aim was to study the association between H. pylori-positive gastritis and the occurrence of any colonic neoplasm.

From a computerized database of surgical pathology reports, we selected 156,000 subjects who underwent colonoscopy and esophago-gastro-duodenoscopy with biopsy results from both procedures.

Compared with normal gastric mucosa, H. pylori gastritis occurred more frequently among patients with hyperplastic polyps (OR=1.24, 95% CI: 1.18-1.30), adenomatous polyps (1.52, 1.46-1.57), advanced adenomas (1.80, 1.69-1.92), villous adenomas or adenomas with high-grade dysplasia (1.97, 1.82-2.14), and adenocarcinomas (2.35, 1.98-2.80). Similarly, the strength of the association between H. pylori-positive gastritis and colonic neoplasm increased with size and number of the adenomas. The association between H. pylori gastritis and the occurrence of colonic neoplasm was similar for different locations of the large bowel. Other gastric conditions etiologically associated with H. pylori, such as intestinal metaplasia, adenoma, lymphoma, and adenocarcinoma, were also significantly associated with an increased risk of colonic neoplasm.

Various forms of gastritis related to H. pylori infection confer an increased risk for colonic neoplasm. In the past, when H. pylori infection was more prevalent, its attributable risk to the occurrence of colorectal neoplasm may have been quite substantial.

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Available from: Robert M Genta, Jan 01, 2015
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    • "Therefore, they were not extracted for the performance of this study. In the recent past, this database has been utilized for a large variety of histo-epidemiologic studies [13] [14] [15] [16] [17] [18]. For the purpose of the present study, the database was searched for all records of patients who underwent an esophagogastro-duodenoscopy (EGD) between January 1, 2008 and August 17, 2013. "
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    ABSTRACT: The aim of the study was to utilize a large national histopathology database for the analysis of the clinical epidemiology of gastric polyps. In a case-control study, 71,575 case subjects with gastric polyps were compared to 741,351 control subjects without gastric polyps. Of all patients, 7.72% harboured fundic gland polyps, 1.79% gastric hyperplastic polyps, 0.09% gastric adenomas, and 0.06% type I neuroendocrine tumours. All types showed a clear-cut age-dependent rise. Reflux disease was significantly more common in patients with fundic gland polyps and significantly less common in patients with gastric adenomas or neuroendocrine tumours. Anaemia was more common in patients with gastric hyperplastic polyps, gastric adenomas, or neuroendocrine tumours. Helicobacter pylori was found significantly less frequently in all subjects with gastric polyps than in controls. Intestinal metaplasia and gastric atrophy were both more common in gastric adenoma and neuroendocrine tumours and less common in fundic gland polyps than in controls. Different polyp types tended to coincide in the same patients. Gastric hyperplastic polyps appeared to mark the beginning of a progression from chronic gastritis to intestinal metaplasia and gastric atrophy, which leads to diminished gastric acid output and increased gastrin secretion. Gastric adenoma and neuroendocrine tumours reflect later stages of this process. Copyright © 2014. Published by Elsevier Ltd.
    Digestive and Liver Disease 11/2014; 47(2). DOI:10.1016/j.dld.2014.10.004 · 2.96 Impact Factor
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    • "Changes in nucleotide sequence, single nucleotide polymorphism (SNP), such an insulin growth factor 1 (IGF1) could have an impact on developing CRC and is a high risk for colorectal polyps (Feik et al., 2010). More recent studies have shown another risk factor, H. pylori infection, confers an increased risk for colonic neoplasm (Sonnenberg et al., 2012). For race factors, the Chinese had a higher incidence of CRC than Malaysian but developed colorectal cancer at a later age in Brunei Darussalam (Chong et al., 2009). "
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    • "Helicobacter pylori infection represents a risk factor for adenomatous polyps and adenocarcinoma of the colon caused by chronic inflammation35 and H. pylori poses an increasing challenge to the clinical management of the infection.36 An intravenous injection of clodronate liposomes inhibited expression of macrophage related cytokines, reduced H. bilis colonization, and H. bilis induced typhlocolitis by depleting macrophages in a Rag2−/− mouse model.37 "
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