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©The Author(s) 2020.
World J Gastroenterol. Jul 14, 2020; 26(26): 3834-3850
Published online Jul 14, 2020. doi: 10.3748/wjg.v26.i26.3834
Published online Jul 14, 2020. doi: 10.3748/wjg.v26.i26.3834
Table 1 Baseline demographic and clinical characteristics of patients who underwent Helicobacter pylori eradication
Parameters | Patients (n = 85) |
Age, mean (SD), yr | 56.1 (12.3) |
Gender, n (%) | |
Female | 53 (62.4) |
BMI, mean (SD), kg/m2 | 25.1 (2.2) |
Alcohol users (12-24 g/dL /die), n (%) | 27 (31.8) |
Previous smokers, n (%) | 12 (14.1) |
Drug users, n (%) | 23 (27.1) |
Family history of gastric cancer, n (%) | 4 (4.7) |
Family history of other cancer, n (%) | 9 (10.6) |
Autoimmune comorbidity | |
Autoimmune atrophic gastritis | 12 (14.1) |
Autoimmune thyroiditis | 6 (7.1) |
Type-1/2 diabetes mellitus | 3 (3.5) |
Skin psoriasis | 1 (1.2) |
Rheumatoid arthritis | 1 (1.2) |
Sjögren syndrome | 1 (1.2) |
A. thyroiditis + vitiligo | 1 (1.2) |
A. thyroiditis + Crohn’s disease | 1 (1.2) |
A. thyroiditis + Sjögren syndrome | 1 (1.2) |
APCA and/or AIF antibody positivity | 12 (14.1) |
Endoscopy indication, n (%) | |
Gastroesophageal reflux | 17 (20) |
Recurrent abdominal pain | 12 (14.1) |
Dyspepsia | 41 (48.2) |
Unexplained anemia | 15 (17.7) |
H. pylori eradication scheme, n (%) | |
Quadruple1 | 53 (62.4) |
Modified triple2 | 28 (32.9) |
Triple3 | 3 (3.6) |
Sequential4 | 1 (1.2) |
H. pylori eradication cycles, n (%) | |
One-cycle | 71 (83.5) |
Two-cycles | 14 (16.5) |
Table 2 Endoscopic and histological characteristics of patients before and after Helicobacter pylori eradication
Parameters | Before H. pylori eradication (n = 85) | After H. pylori eradication (n = 85) | P value |
Endoscopic atrophy1, n (%) | |||
Absent | 5 (5.9) | 4 (4.7) | 1.0 |
Antrum | 19 (22.4) | 19 (22.4) | 1.0 |
Antrum-predominant | 18 (21.2) | 12 (14.1) | 0.23 |
Corpus-predominant | 21 (24.7) | 23 (27.1) | 0.73 |
Pan-atrophy | 22 (25.9) | 27 (31.8) | 0.40 |
OLGA-scale, n (%) | |||
Stage 0 | 4 (4.7) | 4 (4.7) | 1.0 |
Stage 1 | 22 (25.9) | 28 (32.9) | 0.31 |
Stage 2 | 34 (40) | 23 (27.1) | 0.07 |
Stage 3 | 20 (23.5) | 25 (29.4) | 0.38 |
Stage 4 | 5 (5.9) | 5 (5.9) | 1.0 |
EGGIM-scale, n (%) | |||
0-2 | 47 (55.3) | 45 (52.9) | 0.76 |
3-4 | 21 (24.7) | 10 (11.8) | 0.03a |
5-6 | 12 (14.1) | 21 (24.7) | 0.08 |
7-8 | 4 (4.7) | 4 (4.7) | 1.0 |
9-10 | 1 (1.2) | 5 (5.9) | 0.21 |
OLGIM-scale, n (%) | |||
Stage 0 | 40 (47.1) | 29 (34.1) | 0.08 |
Stage 1 | 14 (16.5) | 17 (20) | 0.55 |
Stage 2 | 14 (16.5) | 14 (16.5) | 1.0 |
Stage 3 | 13 (15.3) | 18 (21.2) | 0.32 |
Stage 4 | 4 (4.7) | 7 (8.2) | 0.53 |
Gastritis at histology2, n (%) | |||
Quiescent | 0 | 81 (95.3) | < 0.0001b |
Mild | 19 (22.4) | 4 (4.7) | 0.001b |
Moderate | 46 (54.1) | 0 | < 0.0001b |
Severe | 20 (23.5) | 0 | < 0.0001b |
MALT-hyperplasia, n (%) | |||
Absent | 46 (54.1) | 82 (96.5) | < 0.0001b |
Mild | 25 (29.4) | 3 (3.5) | < 0.0001b |
Moderate | 11 (12.9) | 0 | 0.007b |
Severe | 3 (3.5) | 0 | 0.24 |
Histological LGD3, n (%) | |||
Absent | 70 (82.4) | 57 (67.1) | 0.02a |
On random biopsies | 15 (17.6) | 9 (10.6) | 0.19 |
On random + on lesions biopsies | 0 | 6 (7) | 0.03b |
Only on visible lesions | 0 | 13 (15.3) | 0.0001b |
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 |
Table 4 Probability of detecting low-grade dysplasia randomly or on visible lesions after Helicobacter pylori eradication
Univariate | Multivariate | |||
Variable | OR (95% CI) | P value | OR1 (95%CI) | P value |
Age, yr | 1.05 (1.01-1.11) | < 0.02 | 1.05 (1.00-1.10) | 0.07 |
Gender | ||||
Female | 1.002 | - | ||
Male | 1.73 (0.69-4.37) | 0.24 | - | - |
BMI, kg/m2 | 0.93 (0.75-1.15) | 0.49 | - | - |
Alcohol use | ||||
No | 1.002 | 1.002 | ||
Yes | 4.33 (1.63-11.51) | < 0.01 | 3.88 (1.31-11.49) | 0.01 |
Drug use | ||||
No | 1.002 | - | ||
Yes | 1.45 (0.54-3.94) | 0.46 | - | - |
MALT hyperplasia regression/reduction | ||||
No | 1.002 | - | ||
Yes | 3.90 (1.20-7.91) | < 0.02 | 3.10 (1.05-9.12) | 0.04 |
APCA and/or AIF antibody positivity | ||||
No | 1.002 | |||
Yes | 5.30 (1.44-19.56) | 0.01 | 5.47 (1.33-22.39) | < 0.02 |
- Citation: Panarese A, Galatola G, Armentano R, Pimentel-Nunes P, Ierardi E, Caruso ML, Pesce F, Lenti MV, Palmitessa V, Coletta S, Shahini E. Helicobacter pylori-induced inflammation masks the underlying presence of low-grade dysplasia on gastric lesions. World J Gastroenterol 2020; 26(26): 3834-3850
- URL: https://www.wjgnet.com/1007-9327/full/v26/i26/3834.htm
- DOI: https://dx.doi.org/10.3748/wjg.v26.i26.3834