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Risk for Colorectal Neoplasia in Patients With Helicobacter pylori Infection: A Systematic Review and Meta-analysis.

ABSTRACT: OBJECTIVES:Helicobacter pylori may reportedly be associated with extragastric malignancy beyond gastric cancer. The present study aimed to evaluate the association between H. pylori infection and colorectal neoplasia through a systematic review and meta-analysis. METHODS:The literature search aimed to retrieve all relevant studies published up to September 2019 that examined the risk for colorectal neoplasia including colorectal adenoma, advanced adenoma, and cancer in patients with H. pylori infection. Meta-analysis was performed to calculate pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs). If publication bias was observed, the pooled OR was adjusted using the trim-and-fill method. RESULTS:Forty-eight studies including 171,045 patients were evaluated, of which 24, 8, and 31 reported H. pylori-associated risk for adenoma, advanced adenoma, and cancer, respectively. H. pylori infection was associated with a significantly higher risk for colorectal adenoma (pooled OR 1.49 [95% CI 1.37-1.62]). H. pylori infection was also associated with a higher risk for advanced colorectal adenoma (pooled OR 1.50 [95% CI 1.28-1.75]). The risk for colorectal cancer in patients with H. pylori infection was also identified (pooled OR 1.44 [95% 1.26-1.65]). Although publication bias was identified in the analysis for colorectal adenoma, the pooled estimate was not significantly changed after adjustment (pooled OR 1.39 [95% CI 1.27-1.52]). DISCUSSION:Although this meta-analysis based on the observational studies could not show causality, it demonstrated that colorectal adenoma, advanced adenoma, and cancer were all associated with H. pylori infection.

SUBMITTER: Choi DS

PROVIDER: S-EPMC7145030 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Risk for Colorectal Neoplasia in Patients With Helicobacter pylori Infection: A Systematic Review and Meta-analysis.

Choi Da Sol DS Seo Seung In SI Shin Woon Geon WG Park Chan Hyuk CH

Clinical and translational gastroenterology 20200201 2

<h4>Objectives</h4>Helicobacter pylori may reportedly be associated with extragastric malignancy beyond gastric cancer. The present study aimed to evaluate the association between H. pylori infection and colorectal neoplasia through a systematic review and meta-analysis.<h4>Methods</h4>The literature search aimed to retrieve all relevant studies published up to September 2019 that examined the risk for colorectal neoplasia including colorectal adenoma, advanced adenoma, and cancer in patients wi ...[more]

PMID: 32032128

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Project description:OBJECTIVES:Many studies have explored the association between Helicobacter pylori infection and osteoporosis. However, the results remain controversial. Therefore, we performed this systematic review and meta-analysis to evaluate the association between H. pylori infection and osteoporosis. DESIGN:Systematic review and meta-analysis of case-control studies. DATA SOURCES:Databases, including PubMed, Embase, Web of Science and Chinese Biomedical Literature Database, were screened from inception to 30 April 2018. ELIGIBILITY CRITERIA:Case-control studies aimed at assessing the association between H. pylori infection and osteoporosis. DATA EXTRACTION AND ANALYSIS:Study characteristics and study quality sections were reviewed. Studies were selected, and data were extracted by two reviewers. Pooled ORs and 95% CIs were calculated using random effects model if heterogeneity existed; otherwise, fixed effects model was used. Subgroup analyses were performed to explore the source of heterogeneity. Publication bias and sensitivity analyses were also tested. RESULTS:A total of 21 studies with 9655 participants were included in our analyses. Taking together, we found that H. pylori infection was associated with increased odds of osteoporosis (OR (95% CI): 1.39 (1.13 to 1.71)); there was no significant difference between osteoporosis and osteopaenia; the association between osteoporosis and H. pylori infection was relatively higher in men than women but did not reach significant level. However, the decrease of bone mineral density in H. pylori-positive patients was not significant when compared with H. pylori negative controls, which may due to the sample size. CONCLUSIONS:Our meta-analysis suggests an association between osteoporosis and H. pylori infection. The clinicians should pay more attention to the patients infected with H. pylori. Further studies were still needed to exploring the confounding factors among studies and to elucidate the underlying biological mechanisms.

Project description:BackgroundHelicobacter pylori is an important carcinogenic factor in gastric cancer. Studies have shown that Helicobacter pylori infection is inversely associated with certain diseases such as esophageal cancer and whose infection appears to have a "protective effect." At present, the relationship between Helicobacter pylori infection and esophageal cancer remains controversial. This study was designed to investigate the relationship between Helicobacter pylori infection and the risk of esophageal cancer in different regions and ethnicities.MethodsSystematic search of the articles on the relationship between Helicobacter pylori infection and esophageal cancer from the database with the duration time up to December 2018. This systematic review was performed under the MOOSE guidelines.ResultsThis meta-analysis included 35 studies with 345,886 patients enrolled. There was no significant correlation between Helicobacter pylori infection and esophageal squamous cell carcinoma in the general population (OR: 0.84; 95% CI: 0.64-1.09/OR: 0.74; 95% CI: 0.54-0.97). However, a significant correlation was found in the Middle East (OR: 0.34; 95% CI: 0.22-0.52/95% CI: 0.26-0.44). There was no significant difference in the prevalence of Helicobacter pylori between the case group and the control group in esophageal adenocarcinoma (8.87% vs. 9.67%). The pooled OR was 0.55 (95% CI: 0.43-0.70) or 0.23 (95% CI: 0.15-0.36). When grouped by match or not, the pooled OR of the nonmatching group and the matching group was 0.48/0.21 (95% CI: 0.36-0.65/95% CI: 0.13-0.36) and 0.73/0.71 (95% CI: 0.57-0.92/95% CI: 0.60-0.84), respectively.ConclusionIn the general populations, no significant association was found between Helicobacter pylori infection and the risk of esophageal squamous cell carcinoma. However, lower risk was found in the Middle East. Helicobacter pylori infection may reduce the risk of esophageal adenocarcinoma, but such "protection effect" may be overestimated.

Project description:Background: Glaucoma is the second most common cause of blindness worldwide affecting almost 70 million individuals. Helicobacter pylori (H. pylori) is a widespread pathogen with systematic pathogenicity. This meta-analysis aimed to estimate the contradictory data regarding a potential association between active H. pylori infection and glaucoma. Materials and Methods: A research in MEDLINE/PubMed and Google Scholar was conducted and original studies investigating the relationship between H. pylori infection and glaucoma were included. Analysis was performed with random effects model. The main outcome was the odds ratio (OR) with 95% confidence intervals (CI) of H. pylori infection as a risk factor for glaucoma. A parallel analysis studied the role of active infection as indicated by histology and the titer of anti-H. pylori antibodies. For the anti-H. pylori antibody titers, weighted mean differences (WMD) were estimated between patients and controls. Results: Fifteen studies were included, with 2664 participants (872 patients with glaucoma and 1792 controls), divided into primary open-angle glaucoma (POAG), normal tension glaucoma (NTG) and pseudo-exfoliation glaucoma (PEG). The association between H. pylori infection and overall glaucoma was significant (OR = 2.08, CI 95% 1.48-2.93) with moderate heterogeneity (I2 = 61.54%). After stratification by glaucoma subtype, heterogeneity was eliminated in the NTG subgroup. Studies with healthy controls, and controls with anemia yielded very low or no heterogeneity, respectively. Gastric biopsy to document active H. pylori infection yielded the highest OR (5.4, CI: 3.17-9.2, p < 0.001) and null heterogeneity. For anti-H. pylori antibody titers, there was a significant difference in WMD between patients and controls (WMD 15.98 IU/mL; 95% CI: 4.09-27.87; p = 0.008); values were greater in glaucoma patients, with high heterogeneity (I2: 93.8%). Meta-regression analysis showed that mean age had a significant impact on glaucoma (p = 0.037). Conclusions: Active H. pylori infection may be associated with glaucoma with null heterogeneity, as, beyond histology, quantified by anti-H. pylori titers and increases with age.

Project description:BackgroundAntimicrobial resistance of H. pylori can lead to treatment failure. Importantly, several studies have reported on heteroresistance, i.e. the presence of resistant and susceptible H. pylori populations in the same sample and/or a difference in the susceptibility patterns between biopsy samples. This meta-analysis aims to provide comprehensive data on the prevalence of metronidazole and clarithromycin heteroresistance and the approaches to their detection.Material and methodsA systematic review was performed after the search of MEDLINE, Scopus and Web of Science. The study outcomes were the weighted pooled prevalence of heteroresistance to clarithromycin and metronidazole in H. pylori positive samples and/or isolates with a subanalysis by continent.ResultsA total of 22 studies that had investigated 3852 H. pylori positive patients were included in the meta-analysis. Heteroresistance to clarithromycin was reported in 20 studies, with a weighted pooled prevalence of 6.8% (95% CI 5.1-8.6; 3654 H. pylori positive patients; the substantial heterogeneity I2 = 55.6%). Heteroresistance to metronidazole was reported in 12 studies, with a weighted pooled prevalence of 13.8% (95% CI 8.9-18.6; 1670 H. pylori positive patients; the substantial heterogeneity I2 = 60.9%). The weighted pooled prevalence of clarithromycin heteroresistance was similar in Asia and Europe (p = 0.174584), however, metronidazole heteroresistance was detected more often in Europe (p < 0.00001). Clarithromycin heteroresistance was detected more often by phenotype rather than by using genotyping methods (12 vs 8 studies), whereas heteroresistance to metronidazole was detected only by phenotype.ConclusionThe prevalence of heteroresistance to clarithromycin and/or metronidazole is not negligible and can be detected in approximately 7 and 14% of H. pylori positive samples, respectively. These findings highlight the need to raise the awareness of gastroenterologists and microbiologists to the heteroresistance to clarithromycin and metronidazole in patients with a H. pylori infection.

Dataset Information

Risk for Colorectal Neoplasia in Patients With Helicobacter pylori Infection: A Systematic Review and Meta-analysis.

Publications

Risk for Colorectal Neoplasia in Patients With Helicobacter pylori Infection: A Systematic Review and Meta-analysis.

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