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.

中文翻译：

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幽门螺杆菌感染患者结直肠肿瘤的风险：系统评价和荟萃分析。

目的 据报道，幽门螺杆菌可能与胃癌以外的胃外恶性肿瘤有关。本研究旨在通过系统评价和荟萃分析评估幽门螺杆菌感染与结直肠肿瘤之间的关联。方法 文献检索旨在检索截至 2019 年 9 月发表的所有相关研究，这些研究检查了幽门螺杆菌感染患者发生结直肠肿瘤的风险，包括结直肠腺瘤、晚期腺瘤和癌症。进行 Meta 分析以计算合并优势比 (OR) 和相应的 95% 置信区间 (CI)。如果观察到发表偏倚，则使用修剪和填充方法调整合并 OR。结果 共评估了 48 项研究，包括 171,045 名患者，其中 24、8 和 31 项报告了 H. 分别与幽门螺杆菌相关的腺瘤、晚期腺瘤和癌症风险。幽门螺杆菌感染与结直肠腺瘤风险显着升高相关（合并 OR 1.49 [95% CI 1.37-1.62]）。幽门螺杆菌感染也与晚期结直肠腺瘤的高风险相关（合并 OR 1.50 [95% CI 1.28-1.75]）。还确定了幽门螺杆菌感染患者发生结直肠癌的风险（合并 OR 1.44 [95% 1.26-1.65]）。尽管在结直肠腺瘤分析中发现了发表偏倚，但汇总估计值在调整后没有显着变化（汇总 OR 1.39 [95% CI 1.27-1.52]）。讨论 尽管这项基于观察性研究的荟萃分析无法显示因果关系，但它表明结直肠腺瘤、晚期腺瘤和癌症都与幽门螺杆菌感染有关。