Objectives: Both Helicobacter pylori (H. pylori) and colorectal neoplasia (CRN) are frequent entities in gastroenterology. Epidemiological data suggest an association between H. pylori positivity (H. pylori +) and CRN, whereas pathophysiologic considerations substantiate a possible causal relationship. However, the relationship between CRN and H. pylori+ may also be mediated by shared risk factors. Therefore, the aim of this cross-sectional study was to evaluate a possible independent relationship between H.pylori and CRN in a Central European cohort. Methods: We included 5,707 asymptomatic patients in this study. All patients underwent screening colonoscopy and upper gastrointestinal endoscopy. We assessed the association between any and advanced CRN and H. pylori + using multilevel logistic regression. We adjusted for age, sex, a positive family history of colorectal cancer and cardiovascular risk. Results: 1,082 patients (19%) were H. pylori + and 4,625 (81%) H. pylori -. Both patients with CRN and H. pylori had more cardiometabolic risk factors. In both univariate (aOR 1.20 1.10-1.31; p<0.001) and multivariable analysis (aOR 1.20 1.08-1.32; p<0.001), H. pylori + was associated with the diagnosis of any CRN. However, we found that H. pylori + was associated with the presence of advanced CRN (aOR 1.26; 0.96-1.64; p=0.10) only in trend. Conclusions: We found a clustered co-occurrence of CRN and H. pylori. This association persisted after correction for shared cardiometabolic risk factors. We think that our analysis emphasizes the clinical value of H. pylori eradication. Whether "test and treat" H. pylori is warranted to prevent CRN remains unclear but is at least a possibility given the simplicity of "test and treat".


中文翻译：

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幽门螺杆菌与结直肠肿瘤的关系

目的：幽门螺杆菌（H. pylori）和结直肠肿瘤（CRN）都是胃肠病学中的常见疾病。流行病学数据表明幽门螺杆菌阳性 (H. pylori +) 与 CRN 之间存在关联，而病理生理学考虑证实了可能的因果关系。然而，CRN 和幽门螺杆菌+ 之间的关系也可能是由共同的危险因素介导的。因此，这项横断面研究的目的是评估中欧队列中幽门螺杆菌和 CRN 之间可能存在的独立关系。方法：我们在这项研究中纳入了 5,707 名无症状患者。所有患者均接受结肠镜筛查和上消化道内镜检查。我们使用多级逻辑回归评估了任何和晚期 CRN 与幽门螺杆菌 + 之间的关联。我们根据年龄、性别进行调整，结直肠癌和心血管风险的阳性家族史。结果：1,082 名患者 (19%) 为 H. pylori +，4,625 名患者 (81%) 为 H. pylori -。患有 CRN 和幽门螺杆菌的患者都有更多的心脏代谢危险因素。在单变量（aOR 1.20 1.10-1.31；p<0.001）和多变量分析（aOR 1.20 1.08-1.32；p<0.001）中，幽门螺杆菌 + 与任何 CRN 的诊断相关。然而，我们发现 H. pylori + 仅在趋势上与晚期 CRN 的存在相关（aOR 1.26；0.96-1.64；p=0.10）。结论：我们发现 CRN 和幽门螺杆菌呈聚集性共现。在纠正共同的心脏代谢危险因素后，这种关联仍然存在。我们认为我们的分析强调了根除幽门螺杆菌的临床价值。是否“检测并治疗”H.