Association of neoplastic and nonneoplastic colorectal polyps with helicobacter pylori

Helicobacter pylori (H. pylori) is a common gram-negative bacterium found in the gastric mucosa that can secrete urea enzymes and vacuolar toxins. Studies have shown that the prevalence of H. pylori infection in the general population is more than 50%. Some studies have reported a significant statistical relationship between H. pylori and colon adenomatous polyps and colon cancer. However, the relationship between colorectal polyps and H. pylori has not yet been clearly explained. In this retrospective study, the relationship between H. pylori in the stomach and nonneoplastic and neoplastic colorectal polyps in patients who underwent gastroscopy and colonoscopy was investigated. Patients aged 18-100 who underwent endoscopy between 2019 and 2023 were included. Patients with colorectal polyps were divided into the study group and patients without colorectal polyps were divided into the control group. The study group patients were also divided into subgroups as patients with nonneoplastic and neoplastic polyps. Demographic characteristics of the patients were evaluated as age, gender, Charlson-comorbidity-index (CMI), body mass index (BMI). Active and chronic gastritis status, findings in Sydney classification (lymphoid hyperplasia, inflammation, mononuclear activation, metaplasia, atrophy), presence and degree of H. pylori were examined in the gastric mucosa biopsy of the patients. In colorectal polyps, the location in the colon, pedunculated or sessile morphology, solitary or multiple, polyp size (mm), dysplasia, carcinoma in situ and presence of malignancy were examined. Data were evaluated at a significance level of p<0.05 at a 95% confidence interval. There were 71 patients in the control group without colorectal polyps, their F/M ratio was 0.9 and their mean age was 54.7 years. There were 118 patients in the study group, their F/M ratio was 0.6 and their mean age was 62.2. In patients with colorectal polyps, neoplastic polyps were detected in 66 and non-neoplastic polyps in 56. Tubular adenomatous polyps were detected in most patients with neoplastic polyps (58%, n:38). Neoplastic polyps were frequently located in the sigmoid colon-left colon (47%, n:31). Dysplasia was detected in 83% (n:55) of neoplastic polyps, carcinoma in situ in 5% (n:3) and colon carcinoma in 5% (n:3). Hyperplastic polyps were detected in most patients with non-neoplastic polyps (75%, n:42). In patients with non-neoplastic polyps, polyps were detected mostly in the rectum (32%, n:18). H. Pylori was detected in 60.6% (n: 43) in the control group and 31% (n: 38) in the group with colorectal polyps, and this difference was statistically significant (p: 0.0001). H. pylori was detected in 35.7% (n: 20) in patients with non-neoplastic colon polyps and 28.8% (n: 19) in patients with neoplastic polyps, and a statistically significant difference was found compared to the control group (p: 0.001). No statistically significant difference was found between patients with non-neoplastic and neoplastic colorectal polyps in terms of the presence of H. pylori (p: 0.43). In our study, it was observed that there was no relationship between colon polyps and H. pylori. In other words, the presence of H. pylori is not effective in the formation of colon polyps. However, on the other hand, it should be considered to conduct this study in different regions and with larger groups, considering that different results may be obtained. Keywords: Helicobacter pylori, colon polyps, neoplastic polyps, nonneoplastic polyps.