Helicobacter pylori infection, anti-Helicobacter pylori treatment and risk of colorectal cancer and adenoma: an observational study and a meta-analysis
Notice bibliographique
Résumé
Background Recent studies suggest a possible link between Helicobacter pylori (H. pylori) infection and risk of colorectal cancer. We examined the association between H. pylori infection, anti- H. pylori treatment, and colorectal cancer and its precursor, adenoma, based on an observational study and a meta-analysis. Methods The observational study part included 3475 participants undergoing colonoscopy and H. pylori testing within the framework of a screening program in Zhejiang Province, China between March 8 and December 29, 2023. Logistic regression models were used to analyze the associations between H. pylori infection and the risk of colorectal cancer and adenoma. Additionally, a meta-analysis was conducted on the associations of H. pylori infection, anti- H. pylori treatment and risk of colorectal cancer and adenoma. Three databases (PubMed, Embase, and Cochrane Library) were searched for relevant studies from inception up to April 9, 2025. Two reviewers independently screened records for eligibility, extracted summary-level data and assessed study quality. Random-effects models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). Study quality was evaluated using the Newcastle–Ottawa Scale for case–control and cohort studies, and adhering to the Agency for Healthcare Research and Quality's recommendations for cross-sectional studies. Heterogeneity was quantified using I 2 statistics and subgroup analyses were conducted to identify potential sources. We used funnel plots to assess publication bias, and Duval and Tweedie's "trim-and-fill" analysis to correct potential bias. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation system. The protocol for meta-analysis was registered in PROSPERO (CRD42024566640). Findings The observational study found a statistically significant association between H. pylori infection and the odds of colorectal cancer (n = 31, OR=2.57, 95% CI: 1.26–5.39) and adenoma (n = 1245, OR=1.37, 95% CI: 1.19–1.59), especially for advanced adenoma (n = 486, OR=1.94, 95% CI: 1.59–2.38), compared with normal or non-adenomatous lesions (n = 2199). Meta-analysis of this and 54 other studies, with a total of 48,945,236 participants, found that H. pylori infection was positively associated with colorectal cancer (OR = 1.59, 95% CI: 1.39–1.82, I 2 = 89%) and adenoma (OR = 1.47, 95% CI: 1.36–1.59, I 2 = 88%), especially with advanced adenoma (OR = 1.77, 95% CI: 1.56–2.00, I 2 = 65%). The OR of overall colorectal neoplasia (colorectal cancer or adenoma) was 1.49 (95% CI: 1.39–1.60, I 2 = 91%). Based on meta-analysis of 3 retrospective studies, anti- H. pylori treatment was associated with a reduced overall risk of colorectal neoplasia (OR = 0.44, 95% CI: 0.20–0.97, I 2 = 93%). Interpretation H. pylori infection may represent a significant risk factor for the development of colorectal cancer. The effect of anti- H. pylori treatment on colorectal cancer incidence and mortality necessitates further investigation through large-scale, randomized controlled trials with prolonged follow-up durations. Funding This work was supported by National Natural Science Foundation of China (No. 82404341, No. 82273704), Noncommunicable Chronic Diseases-National Science and Technology Major Project (No. 2023ZD0501400-2023ZD0501402), Beijing Hospitals Authority's Ascent Plan (DFL20241102), Peking University Medicine Fund for World's Leading Discipline or Discipline Cluster Development (No. BMU2022XKQ004), Science Foundation of Peking University Cancer Hospital (No. BJCH2024BJ02), Healthy Zhejiang One Million People Cohort (K-20230085), German Research Foundation (DFG, GE 2042/24-1).
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,003 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».