Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 12  |  Issue : 5  |  Page : 15-18

Helicobacter pylori infection and colorectal carcinoma risk: A meta-analysis


1 Department of Chinese and Western Medicine, Tianjin Fourth Center Hospital (Tianjin Medical University Fourth Center Clinical College), Tianjin 300140, P.R. China
2 Department of Hematology-Oncology, Tianjin Fourth Center Hospital (Tianjin Medical University Fourth Center Clinical College), Tianjin 300140, P.R. China
3 Department of Gastroenterology, Tianjin Fourth Center Hospital (Tianjin Medical University Fourth Center Clinical College), Tianjin 300140, P.R. China

Date of Web Publication7-Oct-2016

Correspondence Address:
Yanrong Wang
Department of Gastroenterology, Tianjin Fourth Center Hospital (Tianjin Medical University Fourth Center Clinical College), Tianjin 300140
P.R. China
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.191621

Rights and Permissions
 > Abstract 


Objective: Helicobacter pylori infection and colorectal cancer risk are not clear. We perform this meta-analysis to further evaluate the association between H. pylori infection and colorectal cancer susceptibility.
Methods: The databases of CNKI, Wanfang, PubMed, Medline, EMBASE, and HighWire Press were electronic searched by two reviewers independently. The case–control study or cohort study about H. pylori infection and colorectal cancer risk were included in this meta-analysis. The association between H. pylori infection and colorectal cancer risk was evaluated by odds ratio (OR) and corresponding 95% confidence interval (95% CI).
Results: Fourteen case–control studies related to H. pylori infection and colorectal cancer risk were eventually include in this meta-analysis. The pooled results showed that H. pylori infection slight increase the risk of developing colorectal carcinoma (OR = 1.33, 95% CI: 1.01–1.77, P = 0.05). Moreover, Begg's funnel plot demonstrated no significant publication bias.
Conclusion: Colorectal carcinoma is associated with H. pylori infection. However, for significant heterogeneity across the studies, this results should be further confirmed by large sample size cohort study.

Keywords: Colorectal carcinoma, Helicobacter pylori infection, meta-analysis


How to cite this article:
Zhao Y, Wang X, Wang Y. Helicobacter pylori infection and colorectal carcinoma risk: A meta-analysis. J Can Res Ther 2016;12:15-8

How to cite this URL:
Zhao Y, Wang X, Wang Y. Helicobacter pylori infection and colorectal carcinoma risk: A meta-analysis. J Can Res Ther [serial online] 2016 [cited 2018 Nov 16];12:15-8. Available from: http://www.cancerjournal.net/text.asp?2016/12/5/15/191621




 > Introduction Top


Helicobacter pylori is a Gram-negative, microaerophilic bacterium which was generally found in the stomach. It was identified in 1982 by Australian scientists Barry Marshall and Robin Warren, who found that it was present in a person with chronic gastritis and gastric ulcers. H. pylori infection was the main cause of gastric ulcer. Moreover, it was also believed to be related with the development of gastric cancer. But whether H. pylori infection increasing the risk of developing colorectal cancer was not clear. Several case–control studies evaluate the association between H. pylori infection and colorectal cancer. They found that H. pylori infection can increase the risk of colorectal cancer. However, other studies showed there was no exact correlation between H. pylori infection and colorectal carcinoma risk. Thereafter, we made this meta-analysis by open published studies to further explicate the correlation between H. pylori infection and colorectal cancer risk.


 > Methods Top


Search strategy and studies inclusion

Case–control or cohort studies reporting the correlation between H. pylori infection and colorectal cancer risk were identified through an electronic sensitive search of CNKI, Wanfang, PubMed, Medline, EMBASE, and HighWire Press databases. The following search word was applied: “Colorectal cancer,” “colorectal carcinoma,” and “H. pylori.” Searches were limited to human trials, without language restriction. All references of relevant studies were also reviewed to find other potential relevant papers. The inclusion criteria were: the study design were case–control or cohort study; the colorectal cancer diagnosis was confirmed by pathology or cytology; the number of patients with H. pylori infection can be extracted from the original studies; the exclusion criteria were: duplicated publication data; case report or reviewed; without enough data to calculate the odds ratio (OR).

Data extraction

The whole manuscript and data were reviewed by two reviewers (Yang Zhao and Xuli Wang) independently. Any disagreement was discussed and consulted to another reviewer (Yanrong Wang) for consensus. The general information such as the first author name, paper publication year, country the study performed, study type, and mean age of the included subjects were extracted. Moreover, the number of subjects with H. pylori infection in the case and control group were also extracted from the included studies for calculated the pooled OR.

Statistical analysis

The whole manuscript and data were analyzed by RevMan 5.2 (http://ims.cochrane.org/revman/download) statistical software (http://ims.cochrane.org/revman/download). The correlation between H. pylori infection and colorectal cancer risk was calculated by OR and corresponding 95% confidence interval (95% CI). The heterogeneity across the included studies was assesed by χ2 and I2 tests. The data were pooled by fixed or random effects model according to the heterogeneity test. The publication bias was evaluated by Begg's funnel plot.


 > Results Top


General information for included papers

through searching the database of CNKI, Wanfang, PubMed, Medline, EMBASE and HighWire Press, 14 case–control studies related to H. pylori infection and colorectal cancer risk were eventually include in this meta-analysis. The paper published range from 1991 to 2013 with 1457 colorectal cancer cases and 2305 healthy controls. The general information for included papers was demonstrated by [Table 1].
Table 1: The general information for included papers

Click here to view


Meta-analysis

Fourteen case–control studies related to H. pylori infection and colorectal cancer risk were eventually include in this meta-analysis. The pooled results showed that H. pylori infection slight increase the risk of developing colorectal carcinoma (OR = 1.33, 95% CI: 1.01–1.77, P = 0.05) [Figure 1].
Figure 1: Forest plot for evaluation the Helicobacter pylori infection and colorectal cancer risk

Click here to view


Publication bias

The publication bias for H. pylori infection and colorectal cancer risk was evaluated by Begg's funnel plot. The plot was eudipleural indicating no significant publication bias [Figure 2].
Figure 2: Funnel plot for evaluation the publication bias of Helicobacter pylori infection and colorectal cancer risk

Click here to view



 > Discussion Top


The correlation between H. pylori infection and gastric cancer risk has been verified by most of studies. Talley et al.[15] performed a retrospective study of gastric adenocarcinoma and H. pylori infection. In their study, they evaluated serum samples from 69 patients with histologically confirmed gastric adenocarcinoma (32 with cancer at the cardia and 37 with cancer at other sites) and 218 patients without a history of cancer. They found a close relationship between H. pylori infection and the development of noncardia gastric adenocarcinoma. But whether H. pylori infection can increase the risk of developing colorectal cancer was not clear. Limburg et al.[10] discussed the H. pylori seropositivity and colorectal cancer risk through a prospective study of male smokers. He found that H. pylori carriage does not appear to be an important risk factor for colorectal adenocarcinoma. However, Breuer-Katschinski et al.[6] found statistically significant association between H. pylori infection and colorectal carcinoma in his study performed in 1999. In our present meta-analysis, we included 14 case–control studies that related to H. pylori infection and colorectal cancer risk. For the included 14 studies, 10 paper reported the Hp measurement by IgG, 2 by urea breath test, and 1 not available. The median H. pylori infection rate was 68.24% and 60.43% for the colorectal cancer patients and control subjects, respectively, with a significant difference. The H. pylori infection rate was slightly higher than that of control group. The correlation between H. pylori infection and colorectal cancer risk was further evaluated by pooling the published data. The combined analysis showed that that H. pylori infection slight increase the risk of developing colorectal carcinoma (OR = 1.33, 95% CI: 1.01–1.77, P = 0.05). Moreover, Begg's funnel plot demonstrated no significant publication bias. According to our study, colorectal carcinoma is associated with H. pylori infection. However, for significant heterogeneity across the studies, this result should be further confirmed by large sample size cohort study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
 > References Top

1.
Penman ID, el-Omar E, Ardill JE, McGregor JR, Galloway DJ, O'Dwyer PJ, et al. Plasma gastrin concentrations are normal in patients with colorectal neoplasia and unaltered following tumor resection. Gastroenterology 1994;106:1263-70.  Back to cited text no. 1
    
2.
Moss SF, Neugut AI, Garbowski GC, Wang S, Treat MR, Forde KA. Helicobacter pylori seroprevalence and colorectal neoplasia: Evidence against an association. J Natl Cancer Inst 1995;87:762-3.  Back to cited text no. 2
[PUBMED]    
3.
Ciccotosto GD, McLeish A, Hardy KJ, Shulkes A. Expression, processing, and secretion of gastrin in patients with colorectal carcinoma. Gastroenterology 1995;109:1142-53.  Back to cited text no. 3
[PUBMED]    
4.
Mizuno S, Morita Y, Inui T, Asakawa A, Ueno N, Ando T, et al. Helicobacter pylori infection is associated with colon adenomatous polyps detected by high-resolution colonoscopy. Int J Cancer 2005;117:1058-9.  Back to cited text no. 4
[PUBMED]    
5.
Thorburn CM, Friedman GD, Dickinson CJ, Vogelman JH, Orentreich N, Parsonnet J. Gastrin and colorectal cancer: A prospective study. Gastroenterology 1998;115:275-80.  Back to cited text no. 5
[PUBMED]    
6.
Breuer-Katschinski B, Nemes K, Marr A, Rump B, Leiendecker B, Breuer N, et al. Helicobacter pylori and the risk of colonic adenomas. Colorectal Adenoma Study Group. Digestion 1999;60:210-5.  Back to cited text no. 6
[PUBMED]    
7.
Fireman Z, Trost L, Kopelman Y, Segal A, Sternberg A. Helicobacter pylori: Seroprevalence and colorectal cancer. Isr Med Assoc J 2000;2:6-9.  Back to cited text no. 7
[PUBMED]    
8.
Hartwich A, Konturek SJ, Pierzchalski P, Zuchowicz M, Labza H, Konturek PC, et al. Helicobacter pylori infection, gastrin, cyclooxygenase-2, and apoptosis in colorectal cancer. Int J Colorectal Dis 2001;16:202-10.  Back to cited text no. 8
[PUBMED]    
9.
Siddheshwar RK, Muhammad KB, Gray JC, Kelly SB. Seroprevalence of Helicobacter pylori in patients with colorectal polyps and colorectal carcinoma. Am J Gastroenterol 2001;96:84-8.  Back to cited text no. 9
[PUBMED]    
10.
Limburg PJ, Stolzenberg-Solomon RZ, Colbert LH, Perez-Perez GI, Blaser MJ, Taylor PR, et al. Helicobacter pylori seropositivity and colorectal cancer risk: A prospective study of male smokers. Cancer Epidemiol Biomarkers Prev 2002;11(10 Pt 1):1095-9.  Back to cited text no. 10
    
11.
Meucci G, Tatarella M, Vecchi M, Ranzi ML, Biguzzi E, Beccari G, et al. High prevalence of Helicobacter pylori infection in patients with colonic adenomas and carcinomas. J Clin Gastroenterol 1997;25:605-7.  Back to cited text no. 11
[PUBMED]    
12.
Yufang S, Yan Z, Binbin C, Suli T, Yu L, Xinshu D, et al. Helicobacter pylori and the risk of colorectal cancer: A case-control study. J Mod Oncol 2007;15:1003-6.  Back to cited text no. 12
    
13.
Shmuely H, Passaro D, Figer A, Niv Y, Pitlik S, Samra Z, et al. Relationship between Helicobacter pylori CagA status and colorectal cancer. Am J Gastroenterol 2001;96:3406-10.  Back to cited text no. 13
[PUBMED]    
14.
Nam KW, Baeg MK, Kwon JH, Cho SH, Na SJ, Choi MG. Helicobacter pylori seropositivity is positively associated with colorectal neoplasms. Korean J Gastroenterol 2013;61:259-64.  Back to cited text no. 14
[PUBMED]    
15.
Talley NJ, Zinsmeister AR, Weaver A, DiMagno EP, Carpenter HA, Perez-Perez GI, et al. Gastric adenocarcinoma and Helicobacter pylori infection. J Natl Cancer Inst 1991;83:1734-9.  Back to cited text no. 15
[PUBMED]    


    Figures

  [Figure 1], [Figure 2]
 
 
    Tables

  [Table 1]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  >Abstract>Introduction>Methods>Results>Discussion>Article Figures>Article Tables
  In this article
>References

 Article Access Statistics
    Viewed1498    
    Printed39    
    Emailed0    
    PDF Downloaded178    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]