Study On The Relationship Between Helicobacter Pylori And Its Related Gastric Diseases And Colorectal Adenomas

Objective: To explore the risk factors of colorectal adenoma(CRA),the relationship between Helicobacter pylori(H.pylori,Hp)infection and CRA,as well as the relationship between Hp-associated gastric diseases and CRA.Methods:(1)According to the inclusion and exclusion criteria,the clinical data of 284 inpatients in digestive department and general surgical department of Gansu Provincial People’s Hospital from January 2015 to December 2019 were collected.Among them,141 cases were colorectal polyps,including 110 cases of colorectal adenomatous polyps(CAP)and 31 cases of nonadenomatous polyps(NAP),and 143 cases of normal mucosa(Control group 1).(2)The differences of age,sex,smoking history,gallbladder diseases and cholecystectomy history,nonalcoholic fatty liver disease(NAFLD),diabetes,hypertension and the positive rate of Hp infection between CAP group and normal mucosa group were compared.(3)The CAP group was divided into subgroups according to age,gender as well as number,size(maximum diameter),growth site and pathological type of adenomas.The difference of the positive rate of Hp infection among subgroups was compared.(4)According to gastroscopy,pathological diagnosis and Hp infection,the patients were divided into four subgroups: Hp(-)chronic gastritis(Control group 2),Hp(+)chronic gastritis,Hp(+)gastric hyperplasia and Hp(+)gastric tumor.The incidence rates of gastric disease in CAP group and NAP group was compared with that in normal mucosa group(Control group1).(5)SPSS 23.0 software was used for statistical analysis.T test was used to compare the ages of the two groups;Categorical data between groups with Chi-Square test;ranked data between groups with rank sum test.The risk factors of CRA were analyzed by Binary Logistic Regression,and the odds ratio(OR)and 95% confidence interval(95%CI)were obtained.The difference was statistically significant when P< 0.05.Results:(1)Single-factor analysis and Binary Logistic Regression analysis showed that: age(OR=1.057,P=0.000),smoking history(OR=2.498,P=0.005),gallbladder diseases and cholecystectomy history(OR=2.266,P=0.009),Hp positive infection(OR=2.439,P=0.006)were the independent risk factors of CRA.(2)In CAP group,the positive rate of Hp infection increased with age,the difference was statistically significant(Z=-2.473,P<0.05).Compared with patients younger than 50 years old,the risk of positive Hp infection in the patients aged 50-70 years old(OR=3.021,P <0.05)and older than or equal to 70 years old(OR=6.769,P <0.05)was significantly higher.The positive rate of Hp infection in CAP group had no significant difference in gender as well as number,size,growth site and pathological subtype of adenomas(all P >0.05).(3)In NAP group,the incidence of Hp(+)chronic gastritis and Hp(+)gastric hyperplasia was higher than that of control group 1,but the difference was not statistically significant(P >0.05).In CAP group,the incidence of Hp(+)chronic gastritis(OR=2.672,P=0.001)and Hp(+)gastric hyperplasia(OR=7.838,P=0.000)were higher than that of control group 1,and the difference was statistically significant.There was no significant difference in Hp(+)gastric tumor due to the small sample size.Conclusion:(1)Advanced age,smoking,biliary diseases and history of cholecystectomy as well as infection of Hp were independent risk factors for CRA.(2)Infection of Hp significantly increased the risk of CRA in patients over 70 years old.There was no significant correlation between the number,size,growth site and pathological type of CRA and Hp infection.(3)Hp infection with chronic gastritis and Hp infection with gastric hyperplasia were associated with an increased risk of CRA.