HIGH PREVALENCE OF HELICOBACTER-PYLORI INFECTION IN PATIENTS WITH COLONIC ADENOMAS AND CARCINOMAS

In some uncontrolled studies, a high prevalence of Helicobacter pylori infection unexpectedly has been found in patients with colorectal can cer. The purpose of the study was to investigate the prevalence of H. pylori infection in patients with colonic polyps or cancer. We reviewe d 50 consecutive patients with either colonic adenomas or cancer who e ntered a preliminary case-control study. For each patient, 2 age-and g ender-matched control subjects were selected (72 males; mean age, 63.1 years). A further 44 consecutive patients (30 with polyps and 14 with cancer) subsequently were enrolled. The H. pylori prevalence in patie nts with either polyps or cancer was compared with that in control sub jects. Anti-H. pylori immunoglobulin G antibodies were assayed by an i mmunoenzymatic method. The prevalence of H. pylori antibodies was 49 ( 49%) of 100 in control subjects, 40 (71.4%) of 56 in patients with pol yps (p < 0.006 vs. control subjects), and 21 (55%) of 38 in patients w ith cancer (not significant). Among patients with colorectal cancer, H . pylori prevalence was 9 (69.2%) of 13 for patients evaluated at the time of diagnosis and 12 (48%) of 25 for patients evaluated 1 to 9 yea rs after surgery. We conclude that colonic neoplastic lesions, especia lly adenomas, are associated with an increased prevalence of H. pylori infection. The mechanisms underlying this association need to be eluc idated.