title: Effect of Helicobacter pylori infection and its eradication on the fate of gastric polyps.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  H. pylori infection increased the risk of hyperplastic polyps in both cross-sectional and longitudinal settings, and its eradication induced regression of hyperplastic polyps.
authors.affiliation: 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.
authors.forename: Su Youn
authors.initials: SY
authors.lastname: Nam
authors.forename: Bum Joon
authors.initials: BJ
authors.lastname: Park
authors.forename: Kum Hei
authors.initials: KH
authors.lastname: Ryu
authors.forename: Ji Hyung
authors.initials: JH
authors.lastname: Nam
mesh_terms: D018256:Adenomatous Polyps / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D016009:Chi-Square Distribution; D016145:Endoscopy, Digestive System; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000472:pathogenicity; D006801:Humans; D006965:Hyperplasia; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D016896:Treatment Outcome