Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary?

Esmaeilzadeh, Abbas; Goshayeshi, Ladan; Bergquist, Robert; Jarahi, Lida; Khooei, Alireza; Fazeli, Alireza; Mosannen Mozaffari, Hooman; Bahari, Ali; Oghazian, Mohammad Bagher; Hoseini, Benyamin

doi:10.1186/s12885-021-08626-6

Table 2 Association of precancerous conditions, abnormal gastric biopsy, atrophy, metaplasia and dysplasia with demographic and clinical characteristics of the dyspeptic patients

From: Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary?

Categorical variable	Precancerous conditions (n = 585)		P-value	Abnormal gastric biopsy (n = 585)		P-value	Atrophy (n = 585)		P-value	Metaplasia (n = 585)		P-value	Dysplasia (n = 585)		P-value
	Yes (n = 122)	No (n = 463)		Yes (n = 103)	No (n = 482)		Yes (n = 74)	No (n = 511)		Yes (n = 89)	No (n = 496)		Yes (n = 46)	No (n = 539)
	n (%)	n (%)		n (%)	n (%)		n (%)	n (%)		n (%)	n (%)		n (%)	n (%)
Age (years)
< = 40	7 (5.7)	208 (44.9)	0.001	59 (57.3)	156 (32.4)	0.001	2 (2.7)	213 (41.7)	0.001	5 (5.6)	210 (42.3)	0.001	2 (4.3)	213 (39.5)	0.001
41–50	33 (27.1)	91 (19.7)		16 (15.5)	107 (22.4)		13 (17.6)	111 (21.7)		19 (21.3)	105 (21.2)		16 (34.8)	108 (20.0)
51–60	34 (27.9)	89 (19.2)		16 (15.5)	108 (22.2)		22 (29.7)	101 (19.8)		24 (27.0)	99 (20.0)		9 (19.6)	114 (21.2)
> = 61	48 (39.3)	75 (16.2)		12 (11.7)	111 (23.0)		37 (50.0)	86 (16.8)		41 (46.1)	82 (16.5)		19 (41.3)	104 (19.3)
Sex
Female (n = 397)	76 (62.3)	321 (69.3)	0.15	78 (75.7)	319 (66.2)	0.06	41 (55.4)	356 (69.7)	0.01	52 (58.4)	345 (69.6)	0.04	32 (69.6)	365 (67.7)	0.79
Male (n = 188)	46 (37.7)	142 (30.7)	0.15	25 (24.3)	163 (33.8)	0.06	33 (44.6)	155 (30.3)	0.01	37 (41.6)	151 (30.4)	0.04	14 (30.4)	174 (32.3)	0.79
Smoking
Yes (n = 112)	25 (20.5)	87 (18.8)	0.69	16 (15.5)	96 (19.9)	0.38	17 (23.0)	95 (18.6)	0.37	20 (22.5)	92 (18.5)	0.39	9 (19.6)	103 (19.1)	0.94
No (n = 473)	97 (79.5)	376 (81.2)		87 (84.5)	386 (80.1)		57 (77.0)	416 (81.4)		20 (22.5)	92 (18.5)		9 (19.6)	103 (19.1)
No (n = 473)	97 (79.5)	376 (81.2)		87 (84.5)	386 (80.1)		57 (77.0)	416 (81.4)		69 (77.5)	404 (81.5)		37 (80.4)	436 (80.9)
Addiction^*
Yes (n = 146)	43 (35.2)	103 (22.2)	0.003	19 (18.4)	127 (26.3)	0.09	30 (40.5)	116 (22.7)	0.001	35 (39.3)	111 (22.4)	0.001	17 (36.9)	129 (23.9)	0.05
No (n = 439)	79 (64.8)	360 (77.8)	0.003	84 (81.6)	355 (73.7)	0.09	44 (59.5)	395 (77.3)	0.001	54 (60.7)	385 (77.6)	0.001	29 (63.1)	410 (76.1)	0.05
Alcohol consumption
Yes (n = 50)	11 (9.0)	39 (8.4)	0.85	8 (7.8)	42 (8.7)	0.85	6 (8.1)	44 (8.6)	0.88	6 (6.7)	44 (8.9)	0.86	3 (6.5)	47 (8.7)	0.78
No (n = 535)	111 (81.0)	424 (91.6)	0.85	95 (92.2)	440 (91.3)	0.85	68 (91.9)	467 (91.4)	0.88	83 (93.3)	452 (91.1)	0.86	43 (93.5)	492 (91.3)	0.78
NSAID use
Yes (n = 173)	18 (14.7)	155 (33.5)	0.001	27 (26.2)	146 (30.3)	0.47	11 (14.9)	162 (31.7)	0.003	13 (14.6)	160 (32.3)	0.001	6 (13.0)	167 (31.0)	0.01
No (n = 412)	104 (85.3)	308 (66.5)	0.001	76 (73.8)	336 (69.7)	0.47	63 (85.1)	349 (68.3)	0.003	76 (85.4)	336 (67.7)	0.001	46 (87.0)	372 (69.0)	0.01
Aspirin use
Yes (n = 88)	15 (12.3)	73 (15.8)	0.39	15 (14.6)	73 (15.1)	1.0	13 (17.6)	75 (14.7)	0.51	8 (9.0)	80 (16.1)	0.08	6 (13.0)	82 (15.2)	0.69
No (n = 497)	107 (87.7)	390 (84.2)	0.39	88 (85.4)	409 (84.9)	1.0	61 (82.4)	436 (85.3)	0.51	81 (91.0)	416 (83.9)	0.08	40 (87.0)	457 (84.8)	0.69
Diabetes (types I and II)
Yes (n = 99)	20 (16.4)	79 (17.1)	1.0	13 (12.6)	86 (17.8)	0.25	15 (20.3)	84 (16.4)	0.41	18 (20.2)	81 (16.3)	0.37	6 (13.0)	93 (17.3)	0.46
No (n = 486)	102 (83.6)	384 (82.9)	1.0	90 (87.4)	396 (82.2)	0.25	59 (79.7)	427 (83.6)	0.41	71 (79.8)	415 (83.7)	0.37	40 (87.0)	446 (82.7)	0.46
H. pylori infection
Yes (n = 469)	114 (93.4)	355 (76.7)	0.001	52 (50.5)	417 (86.5)	0.001	68 (91.9)	401 (78.5)	0.007	83 (93.3)	383 (77.8)	0.001	42 (91.3)	427 (79.2)	0.048
No (n = 116)	8 (6.6)	108 (23.3)	0.001	51 (49.5)	65 (13.5)	0.001	6 (8.1)	110 (21.5)	0.007	6 (6.7)	110 (22.2)	0.001	4 (8.7)	112 (20.8)	0.048
Dyspepsia pattern
EPS (n = 245)	50 (41.0)	195 (42.1)	0.99	46 (44.7)	199 (41.3)	0.45	31 (41.9)	214 (41.9)	0.99	37 (41.6)	208 (41.9)	0.99	17 (37.0)	228 (42.3)	0.46
Flatulence (n = 143)	30 (24.6)	113 (24.4)		20 (19.4)	123 (25.5)		18 (24.3)	125 (24.5)		22 (24.7)	121 (24.4)		9 (19.6)	134 (24.9)
Early satiation (n = 48)	11 (9.0)	37 (8.0)		6 (5.8)	42 (8.7)		7 (9.5)	41 (8.0)		7 (7.9)	41 (8.3)		6 (13.0)	42 (7.8)
PF (n = 48)	10 (8.2)	38 (8.2)		9 (8.2)	39 (8.2)		6 (8.1)	42 (8.2)		8 (9.0)	40 (8.1)		6 (13.0)	42 (7.8)
Reflux (n = 101)	21 (17.2)	80 (17.3)		22 (21.4)	79 (16.4)		12 (16.2)	89 (17.4)		15 (16.9)	86 (17.3)		8 (17.4)	93 (17.3)
Endoscopic findings
Normal (n = 121)	5 (4.1)	116 (25.0)	0.001	5 (4.1)	116 (25.0)	0.001	2 (2.7)	119 (23.3)	0.001	5 (5.6)	116 (23.4)	0.001	2 (4.3)	119 (22.1)	0.001
Erythema (n = 176)	23 (18.8)	153 (33.1)		23 (18.8)	153 (33.1)		10 (13.5)	166 (32.5)		12 (13.5)	164 (33.1)		12 (26.1)	164 (30.4)
M o/s (n = 151)	33 (27.1)	118 (25.5)		33 (27.1)	118 (25.5)		18 (24.3)	133 (26.0)		20 (22.5)	131 (26.4)		12 (26.1)	139 (25.8)
Erosion (n = 68)	18 (14.7)	50 (10.8)		18 (14.7)	50 (10.8)		11 (14.9)	57 (11.2)		17 (19.1)	51 (10.3)		6 (13.0)	62 (11.5)
GDU (n = 36)	21 (17.2)	15 (3.2)		21 (17.2)	15 (3.2)		12 (16.2)	24 (4.7)		16 (18.0)	20 (4.0)		7 (15.2)	29 (5.4)
Atrophy (n = 33)	22 (18.1)	11 (2.4)		22 (18.1)	11 (2.4)		21 (28.4)	12 (2.3)		19 (21.3)	14 (2.8)		7 (15.2)	26 (4.8)
FHGC
None (n = 397)	89 (73.0)	308 (66.5)	0.77	75 (72.8)	322 (66.8)	0.012	50 (67.6)	347 (67.9)	0.87	61 (68.5)	336 (67.7)	0.98	38 (82.6)	359 (66.6)	0.53
GC (n = 69)	12 (9.9)	57 (12.3)		13 (12.6)	56 (11.6)		7 (9.5)	62 (12.1)		11 (12.4)	58 (11.7)		3 (6.5)	66 (12.2)
IC (n = 1)	0 (0.0)	1 (0.2)		1 (1.0)	0 (0.0)		0 (0.0)	1 (0.2)		0 (0.0)	1 (0.2)		0 (0.0)	1 (0.2)
CC (n = 81)	17 (13.9)	64 (13.8)		5 (4.9)	76 (15.8)		14 (18.9)	67 (13.1)		13 (14.6)	68 (13.7)		4 (8.7)	77 (14.3)
OC (n = 12)	2 (1.6)	10 (2.2)		2 (1.9)	10 (2.1)		1 (1.4)	11 (2.2)		2 (2.2)	10 (2.0)		0 (0.0)	12 (2.2)
LC (n = 14)	1 (0.8)	13 (2.8)		4 (3.9)	10 (2.1)		1 (1.4)	13 (2.5)		1 (1.1)	13 (2.6)		1 (2.2)	13 (2.4)
PC (n = 11)	1 (0.8)	10 (2.2)		3 (2.9)	8 (1.7)		1 (1.4)	10 (2.0)		1 (1.1)	10 (2.0)		0 (0.0)	11 (2.0)
FHNGC
None (n = 504)	112 (91.8)	392 (84.7)	0.12	81 (78.6)	423 (87.8)	0.04	66 (89.2)	438 (85.7)	0.15	81 (91.0)	423 (85.3)	0.15	42 (91.3)	462 (85.7)	0.64
Breast (n = 34)	2 (1.6)	32 (6.9)		8 (7.8)	26 (5.4)		1 (1.4)	33 (6.5)		1 (1.1)	33 (6.7)		2 (4.3)	32 (5.9)
Cervical (n = 6)	1 (0.8)	5 (1.1)		2 (1.9)	4 (0.8)		1 (1.4)	5 (1.0)		1 (1.1)	5 (1.0)		0 (0.0)	6 (1.1)
Ovarian (n = 6)	2 (1.6)	4 (0.9)		2 (1.9)	4 (0.8)		2 (2.7)	4 (0.8)		2 (2.2)	4 (0.8)		1 (2.2)	5 (0.9)
Bladder (n = 4)	1 (0.8)	3 (0.6)		2 (1.9)	2 (0.4)		1 (1.4)	3 (0.6)		1 (1.1)	3 (0.6)		0 (0.0)	4 (0.7)
Kidney (n = 6)	1 (0.8)	4 (0.9)		3 (2.9)	2 (0.4)		1 (1.4)	4 (0.8)		0 (0.0)	5 (1.0)		1 (2.2)	4 (0.7)
Haematological (n = 12)	0 (0.0)	12 (2.6)		2 (1.9)	10 (2.1)		0 (0.0)	12 (2.3)		0 (0.0)	12 (2.4)		0 (0.0)	12 (2.2)
Pulmonary (n = 14)	3 (2.5)	11 (2.4)		3 (2.9)	11 (2.3)		2 (2.7)	12 (2.3)		3 (3.4)	11 (2.2)		0 (0.0)	14 (2.6)
Continuous variable	mean ± SD	mean ± SD	P-value	mean ± SD	mean ± SD	P-value	mean ± SD	mean ± SD	P-value	mean ± SD	mean ± SD	P-value	mean ± SD	mean ± SD	P-value
Age (years)	57.8 ± 13.1	45.4 ± 13.7	0.001	41.6 ± 12.6	49.3 ± 14.5	0.001	61.0 ± 12.6	46.1 ± 13.7	0.001	59.4 ± 13.2	45.9 ± 13.7	0.001	58.6 ± 14.3	47.1 ± 14.1	0.001
Haemoglobin (Hgb)	13.3 ± 1.6	13.3 ± 1.5	0.48	13.4 ± 1.5	13.3 ± 1.5	0.62	12.9 ± 1.5	13.4 ± 1.5	0.14	13.1 ± 1.6	13.4 ± 1.5	0.12	13.4 ± 1.6	13.3 ± 1.5	0.48
25(OH)D₃ vitamin	21.7 ± 13.0	18.1 ± 11.2	0.002	18.0 ± 11.5	19.0 ± 11.7	0.27	20.8 ± 12.4	18.5 ± 11.6	0.14	22.3 ± 13.7	18.2 ± 11.2	0.004	21.9 ± 11.2	18.6 ± 11.7	0.013

EPS Epigastric pain syndrome; M o/s Mucosal oedema/swelling; PF Postprandial fullness; GDU Gastric or duodenal ulcer; FHGC Family history of gastro-intestinal cancer; FHNGC Family history of non-gastro/intestinal cancer; GC gastric cancer; IC Intestinal cancer; CC Colon cancer; OC Oesophagus cancer; LC Liver cancer; PC Pancreas cancer. ^*Addiction = opium and/or methamphetamine

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