Page 117 - Helicobacter pylori and Gastric Cancer: From Tumor microenvironment to Immunotherapy
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 Further assessments according to factors significant on multivariate analysis
To further assess the disagreement between histological and endoscopic atrophy, patients were cross-tabulated by each factor found to be significant (Table 4). Although the performance of endoscopic evaluation was diminished in extensive atrophy in both populations, the geographical context influenced the extent of this misdiagnosis. More specifically, 24 (19.35%) of the 124 Nigeria patients were misdiagnosed, including 15 who were over-diagnosed with histological atrophy of the antrum or angulus. In contrast, 57 (45.2%) of the 126 Iranian patients, of all histological grades, were misdiagnosed, including 22 who were over-diagnosed and 35 who were under-diagnosed. This further analysis supports the notion that the performance of endoscopic evaluation solely is significantly influence by the different presentation of disease in alternative geographical locations.
Table 4. Factors that significantly associated with reduced concordance between endoscopic and histological atrophy with H pylori-associated gastric atrophy cases.
          Country
Nigeria
Iran
Age (yr)
≥ 40
< 40
Helicobacter pylori IgG Positive Negative Pepsinogen I/II ratio > 3.0
≤ 3.0 Endoscopic atrophy No atrophy Others
Adjusted OR (95%CI)
1
0.23 (0.11–0.56) 1
0.6 (0.31–1.38) 1
0.32 (0.16–0.66) 1
0.50 (0.67–3.35)
1
0.09 (0.04–0.56)
P values
<0.001
0.268
0.008
0.328 0.256
                                           Helicobacter Pylori
Helicobacter pylori
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