Journal of Clinical Trials
Open Access

The Impact Factor of Colon Polyp

Zheng Zhou^* and Guangming Wang ^*Correspondence: Zheng Zhou, Department of Gastroenterology, Xuancheng People's Hospital, Anhui Province, 242000, China, Email:

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Introduction

The polyp of large intestine is a kind of common digestive tract lesion and a mass formed by the proliferation of the large intestine mucosa into the intestinal cavity. Pathologically, it can be divided into proliferative polyp, inflammatory polyp, adenomatous polyp, hamartoma polyp and so on. Hyperplastic polyps and inflammatory polyps generally have no cancerous tendency, adenomatous polyps and hamartomatous polyps have certain cancerous tendency. Recently, the incidence of colorectal cancer have decreased due to increased precancerous lesion screening and resection of early colorectal lesions [1,2]. The incidence of colorectal cancer is related to diet structure, environmental changes, genetic factors, oncogene imbalance and other factors, and there is no definite and effective prevention method at present. Helicobacter pylori are a class of gram-negative microaerobic bacteria. Helicobacter pylori are associated with peptic diseases such as gastritis and peptic ulcer. It is the first carcinogen of gastric cancer. In addition, Helicobacter pylori are also associated with iron deficiency anemia, idiopathic thrombocytopenic purpura, diabetes and other extragastric diseases. Studies have shown that Helicobacter pylori is associated with the risk of colorectal polyps [3,4].

A polyp can have a variety of shapes and be flat, slightly raised (called sessile) or on a stalk (called pedunculated). There are different microscopic types of polyps (which require a microscope to determine), and the adenomas or sessile serrated polyps can eventually grow over time and become cancer. Undergoing colorectal cancer screening and removal of polyps can decrease the risk of developing colorectal cancer. Polyps are found in about 30% of the adult population over the age of 45-50. Men and women of all ethnicities are at risk of colon polyps and colon cancer. A polyp is the result of genetic changes in the cells of the colon lining that affect the normal cell life cycle. Many factors can increase the risk or rate of these changes. Factors are related to your diet, lifestyle, older age, gender and genetics or hereditary issues. The vast majority of polyps are not cancerous or even pre- cancerous. The polyps without the potential to turn into cancer include small hyperplastic polyps, inflammatory polyps, and hamartomatous polyps which are not part of an inherited polyp syndrome. The precancerous polyp which can turn into a cancer is called an adenoma. The two most common types of colorectal polyps are hyperplastic polyps and adenomas. Usually, the larger the size of the adenoma, the greater the chance that there may be cancer or pre-cancerous cells present in the polyp. Since it is hard to determine the exact nature of a polyp, polyps found during colonoscopy are removed and sent to the lab for a microscopic analysis. Current theories propose it will take about 10 years for a small adenoma to transform into a cancer. That is why the standard interval for screening colonoscopy is 10 years. However, the time interval may be shorter for patients with a hereditary form of colon cancer (like familial adenomatous polyposis or hereditary non polyposis colorectal cancer) or inflammatory bowel disease. The recommended intervals are general guidelines and may not apply to every patient.

In this study, through compared Helicobacter pylori infection of large intestine polyp group with control group, and compared Helicobacter pylori infection of different pathological types of polyp and control group, we analyze the relationship between Helicobacter pylori and polyp of large intestine.

Materials and Methods

Objects

The clinical data of 850 patients who underwent both colonoscopy and Helicobacter pylori check were collected in our hospital from January 2018 year to January 2019 year. Exclusion of ulcerative colitis, Crohn’s disease, systemic lupus erythematosus, familial polyposis, familial cancer hereditary disease.

Material

Colonoscope: Olympus CF-H260AZI. Biopsy forceps. Nanjing minimally invasive Medical Technology Co.Ltd. Carbon 14 breath detector, single endoscopic biopsy sampling needle, electron microscope.

Methods

Colonoscopy: All colonoscopy achieved ileocecal site. All polyps were biopsied and sent to pathology during the examination.

Size of lesion: The criterion follow as maximum opening of biopsy forceps (about 0.6 cm) or maximum diameter of tissue after resection by measurement.

Groups and methods: Patients were divided into polyp group and control group. Normal colonscopy was the control group. The colonic polyp as polyp group, to analyze the Helicobacter pylori infection of two groups and the relationship among Helicobacter pylori infection, eradication treatment and recurrence of colonic polyp. Further to analyze the impact factor of the recurrence of colonic polyp.

Helicobacter pylori tests are based on carbon 14 breath test and pathology.

All patients were followed up for one year.

Statistical analysis

Data collected were analyzed using SPSS17.0. The measurement data use t test. The count data use chi-square test. P<0.05 was statistically significant.

Results

Patient’s clinical data

We collected the clinical data of 850 patients who underwentHelicobacter pylori both colonoscopy and Helicobacter pylori in endoscopic room ofHelicobacter pylori our hospital from January 2018 year to January 2019 year. AmongHelicobacter pylori these patients, there were 420 males, 430 females. 304 patients were Helicobacter pylori positive, and 546 patients were Helicobacter pylori negative. Among Helicobacter pylori positive patients, there were 162Helicobacter pylori patients have Helicobacter pylori eradicated, and 142 patients haveHelicobacter pylori not eradicated. In control group, there were 213 patients whoseHelicobacter pylori age over 60 years, and 202 patients whose age less than 60 years. InHelicobacter pylori polyp group, there were 220 patients whose age over 60 years, and 215 patients whose age less than 60 years. In Table 1, there were no significant differences in sex and age aspects of two groups.

Table 1: The comparison of sex and age aspects between two groups.

The colonic polyp and Helicobacter pylori infection

The polyp group has 435 patients, in which there were 192 Helicobacter pylori positive patients, and 243 Helicobacter pylori negative patients. The percentage of Helicobacter pylori positive was 44.1% in polyp group. The control group has 415 patients, in which there were 112 Helicobacter pylori positive patients, and 303 Helicobacter pylori negative patients. The percentage of Helicobacter pylori positive was 36.9% in control group. Through SPSS software analysis, the infection rate of Helicobater pylori was higher in polyp group, and there was significant difference. The results were shown in Table 2.

Table 2: The Helicobacter pylori infection in two groups.

The relationship among Helicobacter pylori infection, eradication treatment and recurrence of colonic polyp

Through SPSS software analysis, the recurrence rate of Helicobacter pyloriin positive patients was higher than Helicobacter pylori in negative patients. The recurrence rate of Helicobacter pylori eradication group was lower than Helicobacter pylori no eradication group, and there was significant difference. The results were shown in Table 3.

Table 3: The relationship among Helicobacter pylori infection, eradication treatment and recurrence of colonic polyp.

The impact factor of the recurrence of colonic polyp

Through SPSS software analysis, the impact factors of the recurrence of colonic polyp include Helicobacter pylori infection, pathological type of polyp and the number of polyps. There was significant difference. The recurrence rate of Helicobacter pylori positive, adenomatous polyps and multiple polyps were higher. The results were shown in Table 4.

Table 4: The impact factor of the recurrence of colonic polyp.

Discussion

With the popularization of colonoscopy, the detection rate of colorectal polyps increased gradually. The colonic polyps are precancerous lesions of colon carcinoma. The canceration rate of colonic polyps range from 1.4% to 9.2% [5]. More than 80% of colonic cancers developed from colonic adenomas. The colonic adenomas have cancerous tendency. The incidence of colonic cancer decreased more than 75% after adenomatous polyp resection [6]. Research shows that Helicobacter pylori infection have relationship with the development of colonic polyp [7,8].

The infection rate of Helicobacter pylori in polyp group was higher in this study. The positive rate of Helicobacter pylori was 44.1% in polyp group, and 36.9% in control group, there was significant difference between polyp group and control group. Research shows that Helicobacter pylori infection have relationship with the recurrence of colonic polyp [7,9]. Helicobacter pylori eradication significantly reduces the risk of colonic polyp recurrence. This study found that the impact factor of colonic polyp recurrence include Helicobacter pylori infection, pathological types of polyp and polyp number. The colonic polyp recurrence rate of Helicobacter pylori positive patients was 66.4%,the Helicobacter pylori negative patients was 33.9%,inflammation polyp was 38%,hyperplasia polyp was 40.5%, adenoma polyp was 48.4%,single polyp was 40.4%, and multiple polyp was 58.7%. The recurrence rate of colonic polyp was higher in Helicobacter pylori positive, adenoma polyp and multiple polyp groups. In addition, the Helicobacter pylori eradication therapy drugs include amoxicillin, clarithromycin, proton pump inhibitor and colloidal bismuth pectin in our study [10]. Compared with Helicobacter pylori no eradication group, the recurrence rate of Helicobacter pylori eradication group was 31.6%, Helicobacter pylori no eradication group was 40.1%. It is indicated that the recurrence rate of Helicobacter pylori eradication group was more lower than Helicobacter pylori no eradication group. This shows that Helicobacter pylori eradication can significantly decrease the recurrent risk of colonic polyp, which indicated that Helicobacter pylori eradication may be the effective approaches to prevent the recurrence of colonic polyp [11,12].

Conclusion

The Helicobacter pylori infection rate of colonic polyp group was higher. The impact factor of colonic polyp recurrence includes Helicobacter pylori infection, pathological types of polyp and polyp number. The recurrence rate of colon polyp was higher in Helicobacter pylori positive, adenoma polyp and multiple polyp group. Therefore, endoscopic treatment in time and Helicobacter pylori eradication can decrease the recurrent risk of colon polyp.

Acknowledgement

We appreciated all authors for analyzed and written the manuscript.

Competing Interests

The authors declare that they have no competing interests.

Funding

Not applicable.

Ethics Approval and Consent to Participate

The clinical research was established, according to the ethical guidelines of the Helsinki Declaration and was approved by the Human Ethics Committee of Xuancheng People’s Hospital. Written informed consent was obtained from individual or Helicobacter pylori guardian participants.

Consent for Publication

Not applicable.

Availability of Data and Material

All data generated or analyzed during this study are included in this published article.

Authors' Contribution

Guangming Wang performed the data collection of colon polyp. Zheng Zhou analyzed and interpreted the patient data regarding the impact factor of colon polyp, and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.

References

1. Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RGS, Barzi A, et al. Colorectal cancer statistics. CA: Cancer J Clin. 2017;67(3):177-193.
2. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics. CA: Cancer J Clin. 2016;66(4):271-289.
3. Chen C, Mao Y, Du J, Xu Y, Zhu Z, Cao H. Helicobacter pylori infection associated with an increased risk of colorectal adenomatous polyps in the Chinese population. BMC Gastroenterol. 2019;19:14.
4. Azeem S, Gillani SW, Siddiqui A, Jandrajupalli SB, Poh V, Sulaiman SA. Diet and colorectal cancer risk in Asia-a systematic review. Asian Pac J Cancer Prev. 2015;16(13):5389-5396.
5. Fu C, Peng T. Relationship between Helicobacter pylori and colorectal polyps occurrence, recurrence and carcinogenesis. JNU. 2018.
6. Kim TJ, Kim ER, Chang DK, Kim YH, Baek SY, Kim K, et al. Helicobacter pylori infection is an independent risk factor of early and advanced colorectal neoplasm. Helicobacter. 2017;22(3):e12377.
7. Lee JY, Park HW, Choi JY, Lee JS, Koo JE, Chung EJ, et al. Helicobacter pylori infection with Atrophic Gastritis is an independent risk factor for advanced colonic neoplasm. Gut Liver. 2016;10(6):902-909.
8. Zuniga R, Bautista J, Sapra K, Westerfield K, Williams S, Sy AM. Combination of triple therapy and chronic ppi use may decrease risk of colonic adenomatous polyps in helicobacter pylori infection. Gastroenterol Res Pract. 2015;2015:638547.
9. Zhan T, Hielscher T, Hahn F, Hauf C, Betge J, Ebert MP, et al. Risk factors for local recurrence of large, flat colorectal polyps after endoscopic mucosal resection. Digestion. 2016;93(4):311-317.
10. Inoue I, Kato J, Yoshimura N, Maeda Y, Moribata K, Shingaki N, et al. Elivated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia. Mol Clin Oncol. 2013;1(1):75-82.