Decreased Colorectal Adenoma Risk After Helicobacter pylori Eradication: A Retrospective Cohort Study
Decreased Colorectal Adenoma Risk After Helicobacter pylori Eradication: A Retrospective Cohort Study
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DOI：
10.1093/cid/ciy591
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发表时间：
2019-06-15
影响因子：
11.8
通讯作者：
Shih, Shou-Chuan
中科院分区：
文献类型：
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作者：
Hu, Kuang-Chun;Wu, Ming-Shiang;Shih, Shou-Chuan
背景。幽门螺杆菌感染与结直肠腺瘤相关，其风险增加1.3- 2.26倍。我们评估幽门螺杆菌与结直肠腺瘤进展之间的关系。这项回顾性队列研究纳入了615名在2006年7月至2015年6月期间无结直肠腺瘤或癌症病史的成年人，他们参加了重复的定期健康筛查检查，其中包括双向胃肠道内窥镜检查。每个受试者的胃活检标本都进行了幽门螺杆菌检测。在随访期间，持续性幽门螺杆菌感染（持续性组）和先前成功根除感染（根除组）的参与者的结直肠腺瘤进展发生率分别为160.52和51.60 / 1000人年（P = 0.0003）。校正混杂因素后，持续性组发生结直肠腺瘤的风险高于根除组（风险比= 3.34,95% CI 1.899, 5.864）。未感染幽门螺杆菌的患者与根除幽门螺杆菌组的结直肠腺瘤发生率相似（23.93% vs 20.12%, P = .328）。持续性幽门螺杆菌感染与结直肠腺瘤的独立发展显著相关。幽门螺杆菌感染可能在结直肠腺瘤的发展中具有病理生理作用，成功根除幽门螺杆菌后，结直肠腺瘤的比例可能会降低。
Background. Helicobacter pylori infection is associated with colorectal adenoma and confers a 1.3- to 2.26-fold increased risk. We evaluated the association between H. pylori and the progression of colorectal adenoma.Methods. This retrospective cohort study included 615 adults with no history of colorectal adenoma or cancer at baseline who participated in a repeated, regular health screening examination, which included a bidirectional gastrointestinal endoscopy, between July 2006 and June 2015. A gastric biopsy specimen from each subject was tested for H. pylori.Results. During follow-up, the incidence rates of colorectal adenoma progression in participants with persistent H. pylori infections (persistent group) and those whose infections had previously been successfully eradicated (eradication group) were 160.52 and 51.60 per 1000 person-years, respectively (P = .0003). After adjustment for confounding factors, the persistent group exhibited a higher risk of colorectal adenoma than the eradication group (hazard ratio = 3.34, 95% CI 1.899, 5.864). The colorectal adenoma ratio of patients uninfected with H. pylori was similar to that of the eradication group (23.93% vs 20.12%, P = .328).Conclusions. Persistent H. pylori infection was associated significantly with the independent development of colorectal adenoma. H. pylori infection may have a pathophysiological role in colorectal adenoma development and, after successful eradication of H. pylori, the colorectal adenoma ratio might decrease.