Case Control Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2022; 14(9): 1689-1698
Published online Sep 15, 2022. doi: 10.4251/wjgo.v14.i9.1689
Inverse relations between Helicobacter pylori infection and risk of esophageal precancerous lesions in drinkers and peanut consumption
Da Pan, Gui-Ju Sun, Ming Su, Xin Wang, Qing-Yang Yan, Guang Song, Yuan-Yuan Wang, Deng-Feng Xu, Nian-Nian Wang, Shao-Kang Wang
Da Pan, Gui-Ju Sun, Yuan-Yuan Wang, Deng-Feng Xu, Nian-Nian Wang, Shao-Kang Wang, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene,School of Public Health, Southeast University, Nanjing 210009, Jiangsu Province, China
Ming Su, Xin Wang, Qing-Yang Yan, Guang Song, Department of Chronic Disease, Huai’an District Center for Disease Control and Prevention, Huai’an 223200, Jiangsu Province, China
Author contributions: Pan D, Wang SK, and Sun GJ designed the research; Pan D, Su M, Yan QY, Song G, Wang YY, Xu DF, and Wang NN conducted the research; Wang SK, Su M, Wang X, and Sun GJ provided essential materials; Pan D analyzed the data and wrote the manuscript; Wang SK had primary responsibility for final content; all authors read and approved the final manuscript.
Supported by the Fellowship of China Postdoctoral Science Foundation, No. 2022M710675; the National Natural Science Foundation of China, No. 81673147; and the Danone Dietary Nutrition Research and Education Foundation, No. DIC2020-08.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Southeast University Zhongda Hospital (No. 2016ZDKYSB017).
Informed consent statement: Written informed consent was obtained from all subjects.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: All data generated or analyzed during this study are included. The technical appendix and statistical procedure are available from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shao-Kang Wang, MD, PhD, Associate Professor, Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, No. 87 Dingjiaqiao, Nanjing 210009, Jiangsu Province, China. shaokangwang@seu.edu.cn
Received: April 7, 2022
Peer-review started: April 7, 2022
First decision: June 2, 2022
Revised: June 16, 2022
Accepted: August 5, 2022
Article in press: August 5, 2022
Published online: September 15, 2022
Processing time: 154 Days and 23.5 Hours
Abstract
BACKGROUND

Helicobacter pylori (H. pylori) is a Gram-negative bacterium found in the upper digestive tract. Although H. pylori infection is an identified risk factor for gastric cancer, its role in esophageal squamous cell carcinoma (ESCC) remains a topic of much debate.

AIM

To evaluate the association between H. pylori infection and the risk of precancerous lesions of ESCC, and further explore the association between dietary factors and the risk of H. pylori infection.

METHODS

Two hundred patients with esophageal precancerous lesions (EPL) aged 63.01 ± 6.08 years and 200 healthy controls aged 62.85 ± 6.03 years were included in this case-control study. Epidemiological data and qualitative food frequency data were investigated. Enzyme-linked immunosorbent assay measuring serum immunoglobulin G antibodies was used to determine H. pylori seropositivity. An unconditional logistic regression model was used to assess the association between H. pylori infection and EPL risk dichotomized by gender, age, and the use of tobacco and alcohol, as well as the association between dietary factors and the risk of H. pylori infection.

RESULTS

A total of 47 (23.5%) EPL cases and 58 (29.0%) healthy controls had positive H. pylori infection. An inverse relation between H. pylori infection and the risk of EPL was found in the group of drinkers after adjustment for covariates [odds ratio (OR) = 0.32, 95% confidence interval (95%CI): 0.11-0.95]. Additionally, peanut intake was significantly associated with a decreased risk of H. pylori infection (OR = 0.39, 95%CI: 0.20-0.74).

CONCLUSION

Our study suggested that H. pylori infection may decrease the risk of EPL for drinkers in a rural adult Chinese population, and the consumption of peanut may reduce the risk of H. pylori infection. These findings should be framed as preliminary evidence, and further studies are required to address whether the mechanisms are related to the localization of lesions and alcohol consumption.

Keywords: Helicobacter pylori; Esophageal precancerous lesions; Peanut consumption; Esophageal squamous cell carcinoma

Core Tip: The association between Helicobacter pylori (H. pylori) infection and esophageal squamous cell carcinoma (ESCC) remains a topic of much debate. This study aimed to evaluate the association between H. pylori infection and the risk of precancerous lesions of ESCC, and further explore the association between dietary intake and the risk of H. pylori infection. Our findings suggested an inverse association between H. pylori infection and the risk of esophageal precancerous lesions in the group of drinkers [odds ratio (OR) = 0.32, 95% confidence interval (95%CI): 0.11-0.95]. Additionally, peanut consumption was significantly associated with a reduced risk of H. pylori infection (OR = 0.39, 95%CI: 0.20-0.74).