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Helicobacter pylori infection and normal colorectal mucosa–adenomatous polyp–adenocarcinoma sequence: a meta‐analysis of 27 case–control studies
Author(s) -
Wang F.,
Sun M. Y.,
Shi S. L.,
Lv Z. S.
Publication year - 2014
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.12290
Subject(s) - medicine , gastroenterology , odds ratio , adenocarcinoma , colorectal adenoma , adenomatous polyps , adenoma , colorectal cancer , helicobacter pylori , meta analysis , risk factor , cancer , colonoscopy
Abstract Aim The study aimed to determine whether H elicobacter pylori infection is associated with colorectal adenocarcinoma and to quantify the extent of the risk. Method A literature search was performed to identify studies published between 1995 and 2012 for relevant risk estimates. Fixed and random effect meta‐analytical techniques were conducted for colorectal adenocarcinoma and adenomatous polyp. Results Twenty‐seven case‐controlled studies involving 3450 adenocarcinoma patients, 1304 adenomatous polyp patients and more than 4000 controls were included. H elicobacter pylori was associated with an increased risk of colorectal adenocarcinoma and adenomatous polyp [odds ratio ( OR ) 1.24, 95% CI 1.12–1.37, P = 0.66; OR 1.87, 95% CI 1.53–2.28, P = 0.81]. There was a significant association between the C agA‐positive strain and adenocarcinoma risk ( OR 1.22, 95% CI 1.08–1.37, P = 0.05). In addition, there was an increased risk of tubular adenoma and villous adenoma formation ( OR 3.06, 95% CI 1.98–4.73, P = 0.14; OR 2.05, 95% CI 0.84–4.97, P = 0.86). Conclusion The meta‐analysis suggests a promoting effect of H elicobacter pylori on the risk of adenocarcinoma. It also suggests that H elicobacter infection might have its influence at the start of the adenomatous polyp disease sequence.