Active Helicobacter pylori Infection and Survival Outcomes in De Novo Metastatic Colorectal Cancer: A Retrospective Cohort Study

IF 4.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2026-07-06 DOI:10.1111/hel.70150

Sait Kitapli, Ali Alkan, Ozgur Tanriverdi

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引用次数: 0

Abstract

Background

The prognostic significance of Helicobacter pylori (H. pylori) infection in metastatic colorectal cancer (mCRC) remains uncertain. Most prior studies have focused on colorectal neoplasia risk and have relied on serological markers rather than assessment of active infection. We evaluated the association between histologically confirmed H. pylori status and clinicopathological features, systemic inflammatory markers, and survival outcomes in patients with de novo mCRC.

Methods

In this retrospective single-center cohort study, consecutive patients diagnosed with de novo mCRC between September 2011 and December 2025 who underwent synchronous upper gastrointestinal endoscopy at diagnosis were included. H. pylori status was determined histopathologically. Overall survival (OS) was estimated using the Kaplan–Meier method and compared with the log-rank test. Prognostic factors were analyzed using univariable and multivariable Cox proportional hazards models with prespecified sensitivity and exploratory interaction analyses.

Results

Among 168 patients, 77 (46%) were H. pylori positive. Right-sided tumors were more frequent in H. pylori–positive patients (43% vs. 17%, p < 0.001), as was BRAF mutation (12% vs. 3%, p = 0.044). Baseline neutrophil-to-lymphocyte ratio was higher in the H. pylori–positive group (median 4.34 vs. 2.74, p = 0.002). Median OS was longer in H. pylori–positive patients (33 vs. 19 months; log-rank p < 0.001). In multivariable analysis, right-sided tumor localization (HR 2.11, 95% CI: 1.648–2.716; p < 0.001), RAS mutation (HR 1.94, 95% CI: 1.612–2.794; p < 0.001), and H. pylori negativity (HR 1.94, 95% CI: 1.569–2.812; p < 0.001) remained statistically significant. These findings were consistent across sensitivity analyses. Significant interactions were observed for tumor sidedness (p < 0.001) and NLR category (p = 0.002).

Conclusions

Histologically confirmed H. pylori positivity was associated with a distinct clinicopathological profile and longer overall survival in patients with de novo mCRC. Given the observational design, these findings should be interpreted as hypothesis-generating and require validation in prospective and multi-center studies.

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查看原文本刊更多论文

活动性幽门螺杆菌感染与新发转移性结直肠癌的生存结局：一项回顾性队列研究。

背景：幽门螺杆菌（h.p ylori）感染对转移性结直肠癌（mCRC）预后的意义尚不确定。大多数先前的研究都集中在结肠直肠癌的风险上，并且依赖于血清学标志物，而不是评估活动性感染。我们评估了组织学证实的幽门螺杆菌状态与新发mCRC患者的临床病理特征、全身炎症标志物和生存结局之间的关系。方法：在这项回顾性单中心队列研究中，纳入了2011年9月至2025年12月期间诊断为新生mCRC并在诊断时接受同步上消化道内镜检查的连续患者。组织病理学检查幽门螺杆菌状态。采用Kaplan-Meier法估计总生存期（OS），并与log-rank检验进行比较。预后因素分析采用单变量和多变量Cox比例风险模型，具有预先指定的敏感性和探索性相互作用分析。结果：168例患者中幽门螺杆菌阳性77例（46%）。右侧肿瘤在幽门螺杆菌阳性患者中更常见（43%对17%，p）。结论：组织学证实的幽门螺杆菌阳性与新发mCRC患者的独特临床病理特征和更长的总生存期相关。考虑到观察设计，这些发现应该被解释为假设产生，需要在前瞻性和多中心研究中验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.