The relationship between colorectal cancer and gastric histopathology: case-control study

Year 2022, , 1145 - 1150, 20.07.2022

Berrin Yalınbaş Kaya , Fuzuli Tuğrul

https://doi.org/10.32322/jhsm.1118677

Abstract

Aim: The aim of this study was to investigate the gastric histopathological findings (Helicobacter pylori (H. pylori), intestinal metaplasia (IM), atrophic gastritis (AG), and dysplasia) in the patients with and without colorectal cancer (CRC).
Material and Method: Two hundred ninety five patients (160 CRC patients and 135 control individuals) were included in the study. Gastric histopathological findings of the patients who underwent upper gastrointestinal (GI) endoscopy were analyzed retrospectively.
Results: H. pylori positivity and IM rates in the CRC patient group were significantly higher than the control group (58.8%&27.8% and 33.1%&19.5%, p<0.001 and p<0.012, respectively). In addition, AG, lymphoplasmocytic infiltration, and dysplasia rates were also higher in the CRC patients compared to the control group. But, they were not statistically significant (p=0.462, p=0.103, and p=0.195, respectively).
Conclusion: In our study, the frequency of H. pylori and IM in patients with CRC was higher than in the control group. Since the prevalence of H. pylori infection is high in Turkey and H. pylori-related gastric diseases may be potential risk factors for colorectal neoplasia, it is recommended that individuals in the high-risk group to be screened for colonoscopy. Also, upper GI endoscopic examination should be performed to screen for gastric premaling lesions in patients with CRC.

Keywords

Helicobacter pylori, colorectal cancer, intestinal metaplasia

Supporting Institution

The authors declared that this study has received no financial support

References

• Mármol I, Sánchez-de-Diego C, Pradilla Dieste A, Cerrada E, Rodriguez Yoldi MJ. colorectal carcinoma: a general overview and future perspectives in colorectal cancer. Int J Mol Sci 2017; 18: 197.
• Kuipers EJ, Grady WM, Lieberman D, et al. Colorectal cancer. Nat Rev Dis Primers 2015; 1: 150-65.
• Simon K. Colorectal cancer development and advances in screening. Clin Interv Aging 2016; 11: 967-76.
• Brenner AT, Dougherty M, Reuland DS. Colorectal cancer screening in average risk patients. Med Clin North Am 2017; 101: 755-67.
• Lucas C, Barnich N, Nguyen HTT. Microbiota, ınflammation and colorectal cancer. Int J Mol Sci 2017; 18: 1310.
• Watari J, Chen N, Amenta PS, et al. Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development. World J Gastroenterol 2014; 20: 5461-73.
• Graham DY. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer. World J Gastroenterol 2014; 20: 5191-204.
• Ozaydin N, Turkyilmaz AS, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the 13C-Urea breath test. BMC Public Health 2013; 13: 12-5.
• Alipour M. Molecular mechanism of Helicobacter pylori-induced gastric cancer. J Gastrointest Cancer 2021; 52: 23-30.
• Huang RJ, Choi AY, Truong CT, Yeh MM, Hwang JH. Diagnosis and management of gastric ıntestinal metaplasia: current status and future directions. Review Gut Liver 2019; 13: 596-03.
• Park YH, Kim N. Review of atrophic gastritis and intestinal metaplasia as a premalignant lesion of gastric cancer. J Cancer Prev 2015; 20: 25–40.
• Smith AM, Watson SA. Gastrin and gastrin receptor activation: an early event in the adenoma-carcinoma sequence. Gut 2000; 47: 820-4.
• Yan Y, Chen YN, Zhao Q, et al. Helicobacter pylori infection with intestinal metaplasia: An independent risk factor for colorectal adenomas. World J Gastroenterol 2017; 23: 1443–9.
• Wu Q, Yang ZP, Xu P, Gao LC, Fan DM. Association between Helicobacter pylori infection and the risk of colorectal neoplasia: a systematic review and meta-analysis. Colorectal Dis 2013; 15: 352-64.
• Hong SN, Lee SM, Kim JH, et al. Helicobacter pylori infection increases the risk of colorectal adenomas: cross-sectional study and meta-analysis. Dig Dis Sci 2012; 57: 2184-94.
• 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: 218-32.
• Choi DS, Seo SI, Shin WG, Park CH. Risk for colorectal neoplasia in patients with Helicobacter pylori infection: a systematic review and meta-analysis. Clin Transl Gastroenterol 2020; 11: e00127
• Imhann F, Bonder MJ, Vich Vila A, et al. Proton pump inhibitors affect the gut microbiome. Gut 2016; 65: 740-8.
• Georgopoulos SD, Polymeros D, Triantafyllou K, et al. Hypergastrinemia is associated with increased risk of distal colon adenomas. Digestion 2006; 74: 42–6.
• Hagymási K, Tulassay Z. Helicobacter pylori infection: new pathogenetic and clinical aspects. Review World J Gastroenterol 2014; 20: 6386-99.
• Grahn N, Hmani-Aifa M, Fransén K, Söderkvist P, Monstein HJ. Molecular identification of Helicobacter DNA present in human colorectal adenocarcinomas by 16S rDNA PCR amplification and pyrosequencing analysis. J Med Microbiol 2005; 54: 1031–5.
• Papastergiou V, Karatapanis S, Georgopoulos SD. Helicobacter pylori and colorectal neoplasia: Is there a causal link? World J Gastroenterol 2016; 22: 649-58.
• Fujimori S, Kishida T, Kobayashi T, et al. Helicobacter pylori infection increases the risk of colorectal adenoma and adenocarcinoma, especially in women. Comparative Study J Gastroenterol 2005; 40: 887-93.
• De Martel C, Parsonnet J. Helicobacter pylori infection and gender: a meta-analysis of population-based prevalence surveys. Dig. Dis. Sci. 2006; 51: 2292-301.
• Wang C,Yan J, He B, Zhang S, Xu S. Hp-positive chinese patients should undergo colonoscopy earlier and more frequently: the result of a cross-sectional study based on 13,037 cases of gastrointestinal endoscopy. Front Oncol 2021; 11: 698898.
• Sonnenberg A, Genta RM. Helicobacter pylori is a risk factor for colonic neoplasms. Am J Gastroenterol 2013; 108: 208–15.
• Limburg PJ, Stolzenberg-Solomon RZ, Colbert LH, et al. Helicobacter pylori seropositivity and colorectal cancer risk: a prospective study of male smokers. Cancer Epidemiol Biomarkers Prev 2002; 11: 1095-9.
• Inoue I, Mukoubayashi C, Yoshimura N, et al. Elevated risk of colorectal adenoma with Helicobacter pylori-related chronic gastritis: a population-based case-control study. Int J Cancer 2011; 129: 2704-11
• Laiyemo AO, Kamangar F, Marcus PM, et al. Atrophic gastritis and the risk of incident colorectal cancer. Cancer Causes Control 2010; 21: 163–70.
• Inoue I, Kato J, Yoshimura N, et al. Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: a follow-up study of patients with endoscopically resected colorectal neoplasia. Mol Clin Oncol 2013; 1: 75–2.
• Machida-Montani A, Sasazuki S, Inoue M, et al. Atrophic gastritis, Helicobacter pylori, and colorectal cancer risk: a case-control study. Helicobacter 2007; 12: 328–32.
• Epplein M, Pawlita M, Michel A, Peek RM, Cai Q, Blot WJ. Helicobacter pylori protein-specific antibodies and risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 2013; 22: 1964-74.
• Kanno T, Matsuki T, Oka M, et al. Gastric acid reduction leads to an alteration in lower intestinal microflora. Biochem Biophys Res Commun 2009; 381: 666–70.
• Lee JY, Park HW, Choi JY, et al. Helicobacter pylori infection with atrophic gastritis ıs an ındependent risk factor for advanced colonic neoplasm. Gut Liver 2016; 10: 902–09.
• Qing Y, Wang M, Lin Y-M, et al. Correlation between Helicobacter pylori-associated gastric diseases and colorectal neoplasia. World J Gastroenterol 2016; 22: 4576–84.
• Lahner E, Vanni AS, Vannella L, et al. No higher risk for colorectal cancer in atrophic gastritis-related hypergastrinemia. Dig Liver Dis 2012; 44: 793-7.
• Chen QF, Zhou XD, Fang DH, et al. Helicobacter pylori infection with atrophic gastritis: An independent risk factor for colorectal adenomas. World J Gastroenterol 2020; 26: 5682–92.
• Liu KS, Wong IO, Leung WK. Helicobacter pylori associated gastric intestinal metaplasia: treatment and surveillance. World J Gastroenterol 2016; 22: 1311-20.
• Evenepoel P, Claus D, Geypens B, et al. Evidence for impaired assimilation and increased colonic fermentation of protein, related to gastric acid suppression therapy. Aliment Pharmacol Ther 1998; 12: 1011-9.
• Ünler GK, Teke Özgür G, Göktürk HS, Korkmaz H, Erinanç ÖH. Is there any association between colonic polyps and gastric intestinal metaplasia? Turk J Gastroenterol 2016; 27: 221