摘要目的 幽门螺杆菌(Hp)感染与结直肠息肉及结直肠癌发生是否相关尚存争议.本研究拟探讨Hp感染与结直肠息肉及结直肠癌发病风险的相关性.方法 纳入2012年5月-2017年5月于北京协和医院行结肠镜检查并经病理确诊的结直肠息肉患者3 483例及初发结直肠癌患者135例,并纳入同期完成全结肠镜检查的健康对照1 925例.所有研究对象同期完成胃黏膜活检快速尿素酶检测.收集息肉数量及大小、结直肠癌部位及Hp感染情况.采用logistic回归分析Hp感染与结直肠息肉、结直肠癌发生的关系.结果 结直肠息肉患者Hp感染发生率为31.5％,高于健康对照(29.5％).校正年龄及性别后,logistic回归分析显示,结直肠息肉患者相对正常对照的Hp感染发生率的OR=1.17(95％CI 1.04～1.32).息肉直径≥1.0 cm者的Hp感染发生率为33.4％,高于息肉直径＜1.0 cm者(31.0％),P=0.03;息肉数量≥2个的患者Hp感染发生率为32.5％,高于单发息肉患者(30.4％),P=0.05.结直肠癌患者Hp感染发生率为36.3％,校正性别及年龄因素后,结直肠癌患者相对正常对照的Hp感染发生率的校正OR=1.56(95％CI 1.06～2.30),P=0.03;结直肠癌的发生部位(左半结肠+直肠癌、右半结肠癌)与Hp感染无关联.结论 结直肠息肉、结直肠癌患者Hp感染发生率高于健康对照组,其中结直肠息肉患者息肉体积大、数量多者Hp感染发生率更高;Hp感染与结直肠癌的分布位置无相关性.

abstractsObjective To investigate the correlations between gastric Helicobacter pylori (Hp) infection and colorectal polyps or cancer.Methods Among patients who finished colonoscopy exams in Peking Union Medical College Hospital (PUMCH) between May 2012 and May 2017,3 483 patients were diagnosed with colorectal polyps,135 patients with newly diagnosed colorectal cancer.A total of 1 925 healthy subjects were enrolled as normal controls.Gastric rapid urease tests (RUT) were done in all patients.General clinical data,RUT results,sizes and numbers of polyps,cancer location were analyzed.Results The proportion of Hp infection in patients with colorectal polyps was 31.5％,higher than that in healthy controls.The odds ratio (OR) of Hp infection in polyp group was 1.17 (95％CI 1.04-1.32) after age and gender were adjusted.The Hp infection rate in patients with polyps over or equal to 1 cm was significantly higher than that in patients with polyps smaller than 1 cm.Patients with more than 1 polyps presented a higher rate of Hp infection than patients with only 1 polyp.Hp infection rate in patients with colorectal cancer was 36.3％,with the adjusted OR 1.56 (95％CI 1.06-2.30).The location of colorectal cancer was not correlated with Hp infection.Conclusions Gastric Hp infection is more common in patients with colorectal polyps than in healthy controls.Polyps ≥1 cm,multiple polyps and colorectal cancer are correlated with higher rates of Hp infection.Cancer location is irrelevant to Hp infection.