METHODS:From a computerized database of surgical pathology reports, we selected 156,000 subjects who underwent colonoscopy and esophago-gastro-duodenoscopy with biopsy results from both procedures.

RESULTS:Compared with normal gastric mucosa, H. pylori gastritis occurred more frequently among patients with hyperplastic polyps (OR=1.24, 95% CI: 1.18-1.30), adenomatous polyps (1.52, 1.46-1.57), advanced adenomas (1.80, 1.69-1.92), villous adenomas or adenomas with high-grade dysplasia (1.97, 1.82-2.14), and adenocarcinomas (2.35, 1.98-2.80). Similarly, the strength of the association between H. pylori-positive gastritis and colonic neoplasm increased with size and number of the adenomas. The association between H. pylori gastritis and the occurrence of colonic neoplasm was similar for different locations of the large bowel. Other gastric conditions etiologically associated with H. pylori, such as intestinal metaplasia, adenoma, lymphoma, and adenocarcinoma, were also significantly associated with an increased risk of colonic neoplasm.

CONCLUSIONS:Various forms of gastritis related to H. pylori infection confer an increased risk for colonic neoplasm. In the past, when H. pylori infection was more prevalent, its attributable risk to the occurrence of colorectal neoplasm may have been quite substantial.

到目前为止规模最大的相关性研究，其中一项结果显示：幽门螺杆菌胃炎和结肠肿瘤密切相关。这项研究也显示，其他类型的幽门螺杆菌感染相关性疾病（比如胃癌）与肿瘤发生的风险增加有关。AmnonSonnenberg（俄勒冈健康与科学大学，波特兰，美国）和Robert Genta（德克萨斯大学西南医学中心，达拉斯，美国）提到，各种类型的肿瘤都存在风险并且风险在肿瘤晚期增加。

这项研究涉及156,269名患者，他们都给予了结肠镜检查和食管—胃—十二指肠检查。Sonnenberg和同事们发现，与无增生性息肉的患者相比，患此病的病人得幽门螺杆菌胃炎的几率增加24%(11%：9%)。肿瘤的分期增加了幽门螺杆菌胃炎的发生率，与无腺瘤和腺癌患者相比，腺瘤和腺癌患者的幽门螺杆菌胃炎发病率都有所增加，分别为52%和 235%(12：9%，18 ：9%)。另外，腺瘤的类型和数目显著增加这种关联性。举个例子，与无息肉患者相比，有10个以上腺瘤的患者得幽门螺杆菌胃炎的几率增加3.4倍(19 %： 9%)，有1-2个腺瘤的患者得幽门螺杆菌胃炎的几率增加1.4倍(12 %：9%)。然而，幽门螺杆菌和息肉部位之间无相关性。

作者还发现，发生结肠肿瘤的风险与其他病理类型（如胃粘膜肠上皮化生、胃腺瘤、胃癌、胃淋巴瘤）有关，但其他幽门螺旋杆菌阴性的疾病与结肠肿瘤之间的关联性不强。