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Background <p>To investigate the epidemiological characteristics of Helicobacter pylori (Hp) infection in Shizuishan of Ningxia and to analyze the associations of Hp infection and the gut microbiota with the development of colorectal cancer (CRC).</p> Methods <p>A cross-sectional study was conducted. From January 2024 to June 2024, 2,000 community residents from 3 areas of Shizuishan City were recruited for Hp screening using the 13C-urea breath test irrespective of digestive symptoms. From this screened community population, 300 healthy controls with normal colonoscopy findings and 100 patients with pathologically confirmed CRC were selected, and stool samples were collected for 16S ribosomal RNA gene sequencing to analyze the gut microbiota. Chi-square test, t test, and multivariable logistic regression were used for statistical analysis.</p> Results <p>The overall Hp positivity rate among screened adults in Shizuishan was 58.4%. The Hp positivity rate in the CRC group (78.0%) was significantly higher than that in the healthy control group (52.3%) (P &lt; 0.001). After adjustment for age, sex, body mass index (BMI), smoking history, and drinking history, Hp infection remained an independent risk factor for CRC (odds ratio (OR) = 2.15, 95% confidence interval (95% CI) 1.42–3.28). Gut microbiota analysis showed that alpha diversity (Shannon index) in the CRC group was significantly lower than that in the healthy control group (P &lt; 0.001) and in the Hp-positive healthy subgroup (P &lt; 0.05). Beta-diversity analysis showed significant separation in microbial community structure among the three groups (Adonis, P &lt; 0.001). Linear discriminant analysis effect size analysis showed enrichment of pathogenic bacteria such as Fusobacterium nucleatum and Escherichia coli in the CRC group, whereas beneficial bacteria that produce short-chain fatty acids, such as Roseburia and Faecalibacterium prausnitzii, were reduced. The microbial community structure of Hp-positive healthy individuals had shown a transitional state between that of Hp-negative healthy individuals and CRC patients.</p> Conclusions <p>The Hp positivity rate among screened community residents was relatively high in Shizuishan, and Hp infection is an independent risk factor for CRC. Hp infection may increase the risk of CRC by disrupting gut microbiota homeostasis and promoting the formation of a pro-carcinogenic microbial community.</p>

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Epidemiological characteristics of Helicobacter pylori infection in Shizuishan and its association with colorectal cancer and the gut microbiota

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月31日

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  • Hailong Qi,
  • Jun Zhu,
  • Jing Yang,
  • Chan Wang,
  • Lei Fu,
  • Xin Chen,
  • Minyuan Li

摘要

Background

To investigate the epidemiological characteristics of Helicobacter pylori (Hp) infection in Shizuishan of Ningxia and to analyze the associations of Hp infection and the gut microbiota with the development of colorectal cancer (CRC).

Methods

A cross-sectional study was conducted. From January 2024 to June 2024, 2,000 community residents from 3 areas of Shizuishan City were recruited for Hp screening using the 13C-urea breath test irrespective of digestive symptoms. From this screened community population, 300 healthy controls with normal colonoscopy findings and 100 patients with pathologically confirmed CRC were selected, and stool samples were collected for 16S ribosomal RNA gene sequencing to analyze the gut microbiota. Chi-square test, t test, and multivariable logistic regression were used for statistical analysis.

Results

The overall Hp positivity rate among screened adults in Shizuishan was 58.4%. The Hp positivity rate in the CRC group (78.0%) was significantly higher than that in the healthy control group (52.3%) (P < 0.001). After adjustment for age, sex, body mass index (BMI), smoking history, and drinking history, Hp infection remained an independent risk factor for CRC (odds ratio (OR) = 2.15, 95% confidence interval (95% CI) 1.42–3.28). Gut microbiota analysis showed that alpha diversity (Shannon index) in the CRC group was significantly lower than that in the healthy control group (P < 0.001) and in the Hp-positive healthy subgroup (P < 0.05). Beta-diversity analysis showed significant separation in microbial community structure among the three groups (Adonis, P < 0.001). Linear discriminant analysis effect size analysis showed enrichment of pathogenic bacteria such as Fusobacterium nucleatum and Escherichia coli in the CRC group, whereas beneficial bacteria that produce short-chain fatty acids, such as Roseburia and Faecalibacterium prausnitzii, were reduced. The microbial community structure of Hp-positive healthy individuals had shown a transitional state between that of Hp-negative healthy individuals and CRC patients.

Conclusions

The Hp positivity rate among screened community residents was relatively high in Shizuishan, and Hp infection is an independent risk factor for CRC. Hp infection may increase the risk of CRC by disrupting gut microbiota homeostasis and promoting the formation of a pro-carcinogenic microbial community.