Objectives: Helicobacter pylori (H. pylori) and colorectal neoplasia (CRN) are frequent entities. 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. All patients underwent screening colonoscopy and upper gastrointestinal endoscopy. We assessed the association between any CRN and advanced CRN with 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 −. Patients with both CRN and H. pylori had more cardiometabolic risk factors. In univariate (aOR 1.20; 1.10–1.31) and multivariable analysis (aOR 1.20; 1.08–1.32), H. pylori + was associated with the diagnosis of any CRN. However, H. pylori + was associated with the presence of advanced CRN (aOR 1.26; 0.96–1.64) 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 suggest 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.”
Med Princ Pract

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 ) 和结直肠癌 (CRN) 是常见的实体。流行病学数据表明幽门螺杆菌阳性 ( H. pylori +) 与 CRN之间存在关联然而，CRN 和H. pylori +之间的关系也可能由共同的危险因素介导。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：我们纳入了 5,707 名无症状患者。所有患者均接受结肠镜检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 CRN 和晚期 CRN 与H. pylori +之间的关联。我们调整了年龄、性别、结直肠癌阳性家族史和心血管风险。结果： 1,082 名患者 (19%) 为H. pylori +，4,625 (81%) 名患者为H. pylori -。同时患有 CRN 和幽门螺杆菌的患者有更多的心脏代谢危险因素。在单变量（aOR 1.20；1.10–1.31）和多变量分析（aOR 1.20；1.08–1.32）中，幽门螺杆菌+ 与任何 CRN 的诊断相关。然而，幽门螺杆菌+ 仅在趋势中与晚期 CRN (aOR 1.26; 0.96–1.64) 的存在相关。结论：我们发现了 CRN 和幽门螺杆菌的集群共现。在校正共同的心脏代谢危险因素后，这种关联仍然存在。我们建议我们的分析强调根除幽门螺杆菌的临床价值。“测试和治疗”幽门螺杆菌是否有必要预防 CRN 尚不清楚，但至少有可能考虑到“测试和治疗”的简单性。
医学实践