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
ARTICLE HIGHLIGHTS
Research background

The role of Helicobacter pylori (H. pylori) infection in esophageal squamous cell carcinoma (ESCC) remains a topic of much debate.

Research motivation

To assess the relationship between H. pylori infection and the risk of precancerous lesions of ESCC, which is an identified early stage of carcinogenesis.

Research objectives

This study aimed to evaluate the association between H. pylori infection and the risk of esophageal precancerous lesions (EPL) in a high-incidence area in Huai’an, and further explore the association between dietary factors and the risk of H. pylori infection.

Research methods

The study was based on a case-control design. Epidemiological data were collected and H. pylori seropositivity was tested. An unconditional logistic regression model was used to analyze the association between H. pylori infection and EPL risk with adjustment for confounders, as well as the association between dietary factors and risk of H. pylori infection.

Research results

The control group had the highest positive rate of H. pylori infection (29.0%), followed by EPL cases of upper and mid thoracic esophagus (24.8%) and EPL cases of lower thoracic esophagus (20.9%). The protective effect of H. pylori infection against the risk of EPL was observed in the group of drinkers after adjustment for covariates [odds ratio (OR) = 0.32, 95% confidence interval (95%CI): 0.11-0.95]. Peanut intake was significantly associated with a reduced risk of H. pylori infection (OR = 0.39, 95%CI: 0.20-0.74).

Research conclusions

H. pylori infection may decrease the risk of EPL in drinkers for a rural adult Chinese population, and the consumption of peanuts may be related to a reduced risk of H. pylori infection.

Research perspectives

A well-designed prospective cohort study is required to address the impact of H. pylori infection on ESCC, the localization of lesions, and the association with dietary intake and alcohol drinking. Additionally, the low prevalence of H. pylori infection in Huai’an is a peculiar finding, which implies that further investigations are recommended.