Helicobacter pylori-induced inflammation masks the underlying presence of low-grade dysplasia on gastric lesions

Table 3 Demographic and clinical characteristics of patients with low-grade dysplasia detected on visible gastric lesions or randomly and without low-grade dysplasia, before and after Helicobacter pylori eradication

Parameters	With LGD (n = 28)	Without LGD (n = 57)	P value
Age, mean (SD), yr	60.9 (8.2)	53.7 (13.4)	0.01a
Gender, n (%)
Female	15 (53.6)	38 (66.7)	0.24
BMI, mean (SD), kg/m2	25 (2.4)	25 (2.3)	1.0
Alcohol users (12-24 g/dL/die), n (%)	15 (53.6)	12 (21.1)	0.002b
Previous smokers, n (%)	10 (35.7)	2 (3.5)	< 0.0001c
Family history of gastric cancer, n (%)	4 (14.3)	0	0.001c
Family history of other cancer, n (%)	6 (21.4)	3 (5.3)	0.001c
Autoimmune comorbidity
Autoimmune atrophic gastritis	8 (28.6)	4 (7)	0.02c
Autoimmune thyroiditis	3 (10.7)	3 (5.3)	0.39
A. thyroiditis + vitiligo	1 (3.6)	0	0.33
A. thyroiditis + Crohn’s disease	1 (3.6)	0	0.33
A. thyroiditis + Sjögren syndrome	0	1 (1.7)	1.0
Sjögren syndrome	0	1 (1.7)	1.0
Type-1/2 diabetes mellitus	1 (3.6)	2 (3.5)	1.0
Skin psoriasis	1 (3.6)	0	0.33
Rheumatoid arthritis	0	1 (1.7)	1.0
APCA and/or AIF antibody positivity	8 (28.6)	4 (7)	0.02c
H. pylori eradication scheme, n (%)
Quadruple1	17 (60.7)	36 (63.2)	0.82
Modified triple2	9 (32.1)	19 (33.3)	0.91
Triple3	1 (3.6)	2 (3.5)	1.0
Sequential4	1 (3.6)	0	0.33
H. pylori eradication cycles, n (%)
One cycle	22 (78.6)	46 (86)	0.82
Two cycles	6 (21.4)	8 (14)	0.82
OLGA scale before5
Stage 0	0	4 (7)	0.3
Stage 1-2	8 (28.6)	48 (84.2)	< 0.0001b
Stage 3-4	20 (71.4)	5 (8.8)	< 0.0001c
OLGA scale after6
Stage 0	0	4 (7)	0.3
Stage 1-2	7 (25)	44 (77.2)	< 0.0001b
Stage 3-4	21 (75)	9 (15.8)	< 0.0001b
OLGIM scale before
Stage 0	0	40 (70.1)	< 0.0001c
Stage 1-2	12 (42.8)	16 (28.1)	0.17
Stage 3-4	16 (57.1)	1 (1.8)	< 0.0001c
OLGIM scale after
Stage 0	0	29 (50.9)	< 0.0001c
Stage 1-2	7 (25)	24 (42.1)	0.12
Stage 3-4	21 (75)	4 (7)	< 0.0001c
Gastritis at histology before, n (%)
Quiescent	0	0	1.0
Mild	3 (10.7)	16 (28.1)	0.10
Moderate-severe	25 (89.3)	41 (71.9)	0.10
Gastritis at histology after, n (%)
Quiescent	26 (92.9)	55 (96.5)	0.59
Mild	2 (7.1)	2 (3.5)	0.50
Moderate-severe	0	0	1.0
MALT hyperplasia before, n (%)
Absent	10 (35.7)	36 (63.2)	0.02b
Mild	10 (35.7)	15 (26.3)	0.37
Moderate	6 (21.4)	5 (8.8)	0.17
Severe	2 (7.2)	1 (1.8)	0.25
MALT hyperplasia after, n (%)
Absent	10 (35.7)	36 (63.2)	0.02b
Mild	18 (64.3)	21 (36.8)	0.02b
Moderate	0	0	1.0
Severe	0	0	1.0

Data are expressed as number of patients and percentage (in parenthesis).

¹Bismuth + Metronidazole + Tetracycline + Proton pump inhibitor.

²Amoxicillin + Levofloxacin + Proton pump inhibitor.

³Amoxicillin + Clarithromycin + Proton pump inhibitor.

⁴Amoxicillin + Clarithromycin + Proton pump inhibitor Amoxicillin (5 d), then Clarithromycin + Metronidazole (5 d) + Proton pump inhibitor.

⁵Before Helicobacter pylori eradication (by Sydney System).

⁶After Helicobacter pylori eradication.

^aBy t-test.

^bBy χ² test.

^cBy Fisher’s exact test. BMI: Body mass index; SD: Standard deviation; APCA: Anti-parietal cell antibody; AIF: Anti-intrinsic factor; H. pylori: Helicobacter pylori; PPI: Proton pump inhibitor; OLGA: Operative Link on Gastritis Assessment; OLGIM: Operative Link on Gastric Intestinal Metaplasia; MALT: Mucosa-associated lymphoid tissue.