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Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps.
Eur J Gastroenterol Hepatol. 2016 Apr; 28(4):449-54.EJ

Abstract

OBJECTIVES

Western guidelines recommend Helicobacter pylori eradication in H. pylori-associated gastric polyps, but Korean medical insurance does not approve its eradication. The aim of this study is to evaluate the effect of H. pylori eradication on gastric polyps.

METHODS

Participants in a large screening cohort underwent baseline and follow-up esophagogastroduodenoscopy and H. pylori testing. The association between gastric polyps and H. pylori was estimated using odds ratios (ORs) adjusted for confounding factors and 95% confidence intervals (CIs). The effect of H. pylori eradication on the fate of polyps was also evaluated.

RESULTS

The screening cohort included 7603 participants (605 gastric polyps: 529 hyperplastic polyps, 63 fundic gland polyps, and 13 adenomas). H. pylori infection showed a positive association with hyperplastic polyps (OR 2.01; 95% CI 1.66-2.41), but was inversely related to fundic gland polyps (OR 0.05; 95% CI 0.02-0.17). Removed polyps by biopsy or endoscopic resection or tiny polyps less than 3 mm at baseline and positive conversion of H. pylori at follow-up were excluded. A total of 7060 persons were finally included to evaluate the effect of H. pylori eradication on the gastric polyp. Successful H. pylori eradication (OR 0.52; 95% CI 0.35-0.77) and persistent H. pylori-negative status (OR 0.59; 95% CI 0.46-0.76) reduced the risk of hyperplastic polyps compared with the persistent H. pylori-positive group. Successful H. pylori eradication markedly induced the disappearance of hyperplastic polyps compared with the persistent H. pylori-positive group (85.0 vs. 29.0%, P=0.001).

CONCLUSION

H. pylori infection increased the risk of hyperplastic polyps in both cross-sectional and longitudinal settings, and its eradication induced regression of hyperplastic polyps.

Authors+Show Affiliations

aDepartment of Gastroenterology, Center for Gastric Cancer, Kyungpook National University Medical Center, Daegu bDepartment of Internal Medicine, Center for Cancer Prevention & Detection, National Cancer Center, Goyang, Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26735158

Citation

Nam, Su Youn, et al. "Effect of Helicobacter Pylori Infection and Its Eradication On the Fate of Gastric Polyps." European Journal of Gastroenterology & Hepatology, vol. 28, no. 4, 2016, pp. 449-54.
Nam SY, Park BJ, Ryu KH, et al. Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps. Eur J Gastroenterol Hepatol. 2016;28(4):449-54.
Nam, S. Y., Park, B. J., Ryu, K. H., & Nam, J. H. (2016). Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps. European Journal of Gastroenterology & Hepatology, 28(4), 449-54. https://doi.org/10.1097/MEG.0000000000000553
Nam SY, et al. Effect of Helicobacter Pylori Infection and Its Eradication On the Fate of Gastric Polyps. Eur J Gastroenterol Hepatol. 2016;28(4):449-54. PubMed PMID: 26735158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps. AU - Nam,Su Youn, AU - Park,Bum Joon, AU - Ryu,Kum Hei, AU - Nam,Ji Hyung, PY - 2016/1/7/entrez PY - 2016/1/7/pubmed PY - 2016/12/15/medline SP - 449 EP - 54 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 28 IS - 4 N2 - OBJECTIVES: Western guidelines recommend Helicobacter pylori eradication in H. pylori-associated gastric polyps, but Korean medical insurance does not approve its eradication. The aim of this study is to evaluate the effect of H. pylori eradication on gastric polyps. METHODS: Participants in a large screening cohort underwent baseline and follow-up esophagogastroduodenoscopy and H. pylori testing. The association between gastric polyps and H. pylori was estimated using odds ratios (ORs) adjusted for confounding factors and 95% confidence intervals (CIs). The effect of H. pylori eradication on the fate of polyps was also evaluated. RESULTS: The screening cohort included 7603 participants (605 gastric polyps: 529 hyperplastic polyps, 63 fundic gland polyps, and 13 adenomas). H. pylori infection showed a positive association with hyperplastic polyps (OR 2.01; 95% CI 1.66-2.41), but was inversely related to fundic gland polyps (OR 0.05; 95% CI 0.02-0.17). Removed polyps by biopsy or endoscopic resection or tiny polyps less than 3 mm at baseline and positive conversion of H. pylori at follow-up were excluded. A total of 7060 persons were finally included to evaluate the effect of H. pylori eradication on the gastric polyp. Successful H. pylori eradication (OR 0.52; 95% CI 0.35-0.77) and persistent H. pylori-negative status (OR 0.59; 95% CI 0.46-0.76) reduced the risk of hyperplastic polyps compared with the persistent H. pylori-positive group. Successful H. pylori eradication markedly induced the disappearance of hyperplastic polyps compared with the persistent H. pylori-positive group (85.0 vs. 29.0%, P=0.001). CONCLUSION: H. pylori infection increased the risk of hyperplastic polyps in both cross-sectional and longitudinal settings, and its eradication induced regression of hyperplastic polyps. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/26735158/Effect_of_Helicobacter_pylori_infection_and_its_eradication_on_the_fate_of_gastric_polyps_ L2 - https://doi.org/10.1097/MEG.0000000000000553 DB - PRIME DP - Unbound Medicine ER -