Page 116 - Helicobacter pylori and Gastric Cancer: From Tumor microenvironment to Immunotherapy

Factors affecting Agreement
To identify factors affecting the agreement between endoscopic and histological atrophy, univariate analyses were performed; factors analyzed included geopgraphy (Nigeria vs Iran), age, sex, H. pylori infection, endoscopic atrophy (no atrophy vs others) and PG I/II ratios. Factors significantly associated with reduced performance of endoscopy included Iran ethnicity (P < 0.001), older age (P < 0.001), a low pepsinogen I/II ratio (P = 0.015), the endoscopic dwetection of atrophy (P < 0.001) and H. pylori infection (P = 0.001) (Table 3). In contrast, age was not significantly associated with reduced Agreement (P = 0.138). Multivariate analysis showed that only three factors were independently associated with reduced agreement: Iranian ethnicity, older age and endoscopic atrophy (Table 4). Thus the performance of endoscopic evaluation is influenced by the geographical context.
Table 3: Factors that significantly associated with reduced concordance between endoscopic and histological atrophy with H pylori Associated gastric atrophy cases.
Agreement group
(n = 180) (%)
Disagreement group
(n = 58) (%)
OR(95%CI)
P value
Country
Nigeria
98 (51.6)
38 (65.5)
0.22 (0.23 -0.76)
<0.001
Iran
92 (48.4)
20 (34.5)
1
Age (yr)
≥ 40
109 (57.4)
30 (51.7)
0.14 (0.09 -0.40)
P=0.148
< 40
71 (42.6)
28 (48.3)
1
Helicobacter pylori IgG
Positive
111 (58.2)
32 (55.2)
0.40 (0.30 -0.55)
P=0.001
Negative
69 (36.3)
26 (44.8)
1
Serologic features (ng/mL)
Pepsinogen I
120 (63.2)
38 (65.5)
0.23 (0.20 -0.45)
P=0.001
Pepsinogen II
70 (36.8)
20 (34.5)
1
Endoscopic atrophy
No atrophy
89 (46.8)
22 (37.9)
1
Others
101 (53.2)
36 (62.1)
0.38 (0.22 -0.67)
<0.001
Chapter 5
Chapter 5
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