Relationship between endoscopic gastric abnormalities and colorectal polyps: a cross-sectional study based on 33439 Chinese patients

Abstract

Background: No study on the relationship between common abnormalities of the upper digestive tract and colorectal polyps (CPs) has been conducted. Methods: 33439 patients were enrolled in this cross-sectional study, of which 7700 had available Helicobacter pylori ( H.pylori ) information. All participants underwent colonoscopy and esophagogastroduodenoscopy (EGD) simultaneously or within six months at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2015 to November 2021. The study assessed whether the risk of CPs was affected by the following gastroesophageal diseases: atrophic gastritis (AG), gastric polyps, Barrett's esophagus and reflux esophagitis, bile reflux, gastric ulcer, gastric mucosal erosion, superficial gastritis, and gastric H.pylori infection. The crude and adjusted odds ratios (ORs) of H.pylori on the occurrence of CPs were computed by logistic regression. Additionally, we also evaluated whether AG had an impact on the relationship between H.pylori infection and CPs. Results: A total of 10600 cases (31.7%) were diagnosed as CPs. Multivariate logistic analysis showed that age, male (OR, 1.80; 95% confidence interval [CI], 1.61 to 2.02), gastric polyps (OR, 1.61; 95% CI, 1.05 to 2.46 for hyperplastic polyps; OR, 1.45; 95% CI, 1.09 to 1.94 for fundic gland polyps), H.pylori infection (OR, 1.21; 95% CI, 1.07 to 1.37) and atrophic gastritis (OR, 1.38; 95% CI, 1.21 to 1.56) were independent risk factors for colorectal polyps. Moreover, the combined effect of H.pylori infection and AG was slightly greater than the sum of their individual effects on the risk of CPs, but there was no additive interaction between them. Conclusions: Gastric conditions including gastric polyps, H.pylori infection, and AG increased the risk of CPs. However, Barrett's esophagus and reflux esophagitis, bile reflux, erosive gastritis, gastric ulcer, and superficial gastritis might not have relationship with CPs occurrence.

Gastric Polyps Detected Incidentally during Gastroscopy and Follow-Up Results

“…While they can appear anywhere in the stomach, they are most commonly found in the antrum and tend to be solitary [ 3 ]. They often occur in the background of atrophic gastritis and intestinal metaplasia, although there is no proven relationship with H. pylori infection [ 3 , 28 ]. In our study, one patient had gastric adenocarcinoma that developed based on an adenoma.…”

“…Feng et al found that the presence of stomach disorders such as GPs, H. pylori infection and atrophic gastritis increased the risk of colorectal polyps (CPs) ( p < 0.001). This relationship was found to be significant in both univariate and multivariate analyses [ 28 ]. The same study also stated that colorectal polyps were statistically more common in hyperplastic and fundic gland polyps [ 28 ].…”

“…This relationship was found to be significant in both univariate and multivariate analyses [ 28 ]. The same study also stated that colorectal polyps were statistically more common in hyperplastic and fundic gland polyps [ 28 ]. There are studies showing that the risk of CP increases in individuals with hyperplastic polyps and fundus gland polyps [ 29 , 30 ].…”

Relationship between Helicobacter pylori infection and colorectal polyp/colorectal cancer

“…Several case-control and retrospective cohort studies have shown a substantial link between H. pylori infection and the prevalence of CP/CRC[ 14 - 17 ]. Similarly, cross-sectional studies conducted in various areas and nations consistently shown that H. pylori infection was an independent risk factor for CP, especially colorectal adenomatous polyp (CAP)[ 18 - 21 ]. Boustany et al [ 22 ] reported the first findings from a large population-based analysis of 47714750 people, establishing an independent link between a history of H. pylori infection and the risk of CRC.…”