Meta-analysis Of The Relationship Between H.pylori Infection And Colorectal Polyps Formation

Objective:The purpose of this study was to summarize the existing evidence of the correlation between H.pylori infection and colorectal polyps formation,conduct a Meta-analysis of relevant observational studies according to the histological type of colorectal polyps,and discuss whether H.pylori infection was independently associated with colorectal polyps,and whether this correlation varied according to the histological type of colorectal polyps.Methods:The literatures related to H.pylori infection and colorectal polyps were searched in Pub Med,EMBASE and Web of Science databases in February 2021.In order to minimize the potential impact of confounding factors such as age and gender on the association between H.pylori infection and colorectal polyps,we only screened the studies for multivariate analysis.Firstly,the research quality of the included literature was evaluated by Newcastle-Ottawa scale（NOS）.Then,the ORs and corresponding 95%CIs of each included study were extracted,and the random effect model was selected by Rev Man and STATA software to combine ORs and 95%CIs.The heterogeneity between included studies was evaluated by Cochran’s Q test and I~2test,and the source of heterogeneity and the stability of research results were investigated by eliminating individual studies one by one for sensitivity analysis.Funnel plots and Egger’s tests were then constructed to assess publication bias.Results:Seventeen studies including 322,395 participants were analyzed.The NOS score showed that the selected literature was of good quality.Meta-analysis showed that H.pylori infection was independently associated with overall colorectal polyps（OR=1.67,95%CI:1.24-2.24,P<0.001）.According to the histological types of colorectal polyps,H.pylori infection was independently associated with adenomatous polyps（OR=1.71,95%CI:1.47-1.99,P<0.001）,advanced adenomatous polyps（OR=2.06,95%CI:1.56-2.73,P<0.001）and proliferative polyps（OR=1.54,95%CI:1.02-2.30,P=0.04）.In addition,evidence based on only one study showed that H.pylori infection was not associated with sessile serrated polyps（OR:1.00,95%CI:0.93-1.07,P=0.99）.There was no publication bias in this study,and the results were stable.Conclusions:These findings suggested that H.pylori infection may be a possible risk factor of colorectal polyp,which was important for the prevention of colorectal polyp in adult population.