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Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps

Nam, Su Youn; Park, Bum Joon; Ryu, Kum Hei; Nam, Ji Hyung

European Journal of Gastroenterology & Hepatology: April 2016 - Volume 28 - Issue 4 - p 449–454
doi: 10.1097/MEG.0000000000000553
Original Articles: Gastro-oesophageal Disorders

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.

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

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Correspondence to Su Youn Nam, MD, PhD, Department of Gastroenterology, Center for Gastric Cancer, Kyungpook National University Medical Center, Kyungpook National University School of Medicine, 807 Hoguk-ro, Buk-gu, Daegu 702-210, Korea Tel: +82 53 200 2610; fax: +82 53 200 2028; e-mail: mascha@medimail.co.kr

Received September 15, 2015

Accepted November 9, 2015

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