Assessing the Correlation between Helicobacter Pylori Infection and Increased Incidence of Colorectal Cancer, Gastric Atrophy, and Intestinal Metaplasia

Abstract

Aim: Our retrospective study was designed to explore the potential link between Helicobacter pylori (H. pylori) infection and the occurrence of colorectal cancer (CRC), gastric atrophy, and intestinal metaplasia. Material and Methods: We assembled two groups of 150 patients each, categorized based on their endoscopic biopsy results for H. pylori - one group testing positive (study group), the other negative (control group). All subjects underwent upper and lower gastrointestinal endoscopies, and we assessed their endoscopic gastric biopsy results as well as any indications of colorectal malignancies. Results: Our investigation established a noteworthy association between the presence of H. pylori infection and the incidences of CRC, gastric atrophy, and intestinal metaplasia (p<0.05). Our data suggests that individuals testing positive for H. pylori faced a 64% greater likelihood of developing CRC compared to those who tested negative. Among patients diagnosed with gastric atrophy, a remarkable 73.9% tested positive for H. pylori. Similarly, 78.9% of patients with intestinal metaplasia were also H. pylori positive. Conclusion: Our results underscore a meaningful correlation between H. pylori infection and a heightened incidence of CRC, gastric atrophy, and intestinal metaplasia. Further, prospective studies will be instrumental in deciphering the underlying causative mechanisms and assessing the feasibility of H. pylori eradication as a preventive measure against these conditions.

Keywords

• Helicobacter pylori
• colorectal cancer
• gastric atrophy
• intestinal metaplasia
• endoscopic biopsy

Kaynakça

1. Hooi JKY, Lai WY, Ng WK, et al. Global prevalence of helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology. 2017;153:420-9.
2. Zamani M, Ebrahimtabar F, Zamani V, et al. Systematic review with meta-analysis: the worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther. 2018;47:868-76.
3. Malfertheiner P, Megraud F, O'Morain CA, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017;66:6-30.
4. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev. 2006;19:449-90.
5. Shmuely H, Passaro D, Figer A, et al. Relationship between Helicobacter pylori CagA status and colorectal cancer. Am J Gastroenterol. 2001;96:3406-10.
6. Chen Y, Segers S, Blaser MJ. Association between Helicobacter pylori and mortality in the NHANES III study. Gut. 2013;62:1262-9.
7. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process--First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992;52:6735-40.
8. Wu Q, Yang ZP, Xu P, et al. Association between Helicobacter pylori infection and the risk of colorectal neoplasia: a systematic review and meta-analysis. Colorectal Dis. 2013;15:e352-64.

9. Shikata K, Kiyohara Y, Kubo M, et al. A prospective study of dietary salt intake and gastric cancer incidence in a defined Japanese population: the Hisayama study. Int J Cancer. 2006;119:196-201.
10. Zuo Y, Jing Z, Bie M, et al. Association between Helicobacter pylori infection and the risk of colorectal cancer: a systematic review and meta-analysis. Medicine (Baltimore). 2020;99:e21832.
11. Eun CS, Kim BK, Han DS, et al. Differences in gastric mucosal microbiota profiling in patients with chronic gastritis, intestinal metaplasia, and gastric cancer using pyrosequencing methods. Helicobacter. 2014;19:407-16.
12. Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R. Association of coffee drinking with total and cause-specific mortality. N Engl J Med. 2012;366:1891-904. Erratum in: N Engl J Med. 2012;367:285.
13. Hong SN. Genetic and epigenetic alterations of colorectal cancer. Intest Res. 2018;16:327-37.
14. Zhang Y, Hoffmeister M, Weck MN, Chang-Claude J, Brenner H. Helicobacter pylori infection and colorectal cancer risk: evidence from a large population-based case-control study in Germany. Am J Epidemiol. 2012;175:441-50.
15. Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394-424. Erratum in: CA Cancer J Clin. 2020;70:313.
16. Plummer M, de Martel C, Vignat J, et al. Global burden of cancers attributable to infections in 2012: a synthetic analysis. Lancet Glob Health. 2016;4:e609-16.
17. Konturek PC, Konturek SJ, Brzozowski T. Helicobacter pylori infection in gastric cancerogenesis. J Physiol Pharmacol. 2009;60:3-21.
18. Polk DB, Peek RM Jr. Helicobacter pylori: gastric cancer and beyond. Nat Rev Cancer. 2010;10:403-14. Erratum in: Nat Rev Cancer. 2010;10:593.
19. Yamaoka Y, Kato M, Asaka M. Geographic differences in gastric cancer incidence can be explained by differences between Helicobacter pylori strains. Intern Med. 2008;47:1077-83.