Helicobacter pylori Infection with Atrophic Gastritis Is an Independent Risk Factor for Advanced Colonic Neoplasm

Abstract

Background/AimsHelicobacter pylori is a major risk factor for atrophic gastritis (AG) and gastric cancer. The correlation between H. pylori, AG and colorectal neoplasm (CRN) has only been examined in a limited number of studies, and findings have been inconclusive. We aimed to investigate the association between H. pylori infection status, AG and advanced CRN.MethodsThis cross-sectional study investigated the relationship between the presence of serum anti-H. pylori IgG antibodies, AG, and advanced CRN in 6,351 consecutive asymptomatic subjects who underwent a screening colonoscopy.ResultsA total of 316 participants (5.0%) had advanced CRN. H. pylori seropositivity was 61.3%. In a univariate analysis, the presence of H. pylori infection was associated with advanced CRN (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.17 to 1.91; p=0.001). H. pylori infection was associated with an increased risk of advanced CRN after adjusting for clinically relevant confounders (OR, 1.34; 95% CI, 1.04 to 1.72; p=0.023). H. pylori-related AG was significantly associated with the risk of advanced CRN (OR, 1.40; 95% CI, 1.03 to 1.91; p=0.030), whereas H. pylori infection without AG was not.ConclusionsH. pylori infection increased the risk of advanced CRN, especially when it was combined with AG. Strict colonoscopy screening and surveillance may be warranted in those with H. pylori-positive AG.

Helicobacter pylori, gastric cancer and other gastrointestinal malignancies

“…Similar data were reported in a retrospective cross‐sectional study on 6,351 Korean subjects (mean age 51.7±8.1 years) who had a GI endoscopy for screening purposes . In this study, Lee et al.…”

Maternal Influence and Murine Housing Confound Impact of NLRP1 Inflammasome on Microbiome Composition

“…2). Interestingly, the abundance of several of the genera in the microbiomes in the Nlrp1b –/– mice are associated with more commensal and pathogenic species known to be associated with inflammation and cancer in the GI tract, including H. pylori [32], H. hepaticus [33], M. schaedleri [34], and C. difficile [35]. It is tempting to speculate that the previously reported increased sensitivity of these knockout animals in models of experimental colitis and colitis-associated tumorigenesis could be due to changes in their microbiome composition [9].…”

“…While these data provide significant mechanistic insight into NLRP1 inflammasome function, recognition of anthrax LeTx and T. gondii do not explain its protective effects during experimental colitis and colitis-associated cancer. The results from our initial microbiome analysis of our separately and individually bred and housed knockout mice identified several bacteria genera that contain species associated with inflammation and cancer in the GI tract, including H. pylori , H. hepaticus , M. schaedleri , and C. difficile , all of which drive colitis and/or tumorigenesis through diverse mechanisms, including: degrading the protective mucus layer in the gut, producing barrier-degrading toxins and metabolites, restricting the growth of probiotic bacteria, and directly inducing acute inflammation [32-35]. This point is particularly compelling in the initial hypothesis that the composition of the microbiome of these animals is the culprit for the sensitivity to colitis in the absence of NLRP1.…”

Is It Rationale to Apply Strict Colonoscopic Surveillance in Patients withHelicobacter pyloriAssociated Chronic Atrophic Gastritis?

“…A population-based case control study conducted in Japan reported proximal adenoma risk increased as the degree of H. pylori -related gastritis increased, showing maximal increase in chronic atrophic gastritis group 2. Lee et al 9. also reported increased prevalence of proximal colon neoplasms in stepwise manner according to the H. pylori seropositivity and presence of atrophic gastritis, showing highest OR (1.29; 95% CI, 1.10 to 1.51) in H. pylori (+)/atrophic gastritis (+) group.…”

“…Lee et al 9. tried retrospective cross-sectional study to evaluate the correlation between H. pylori , atrophic gastritis and colorectal neoplasm using a single center health check program.…”