5- EVALUATION OF ENDOSCOPY BASED METHODS (HISTOPATHOLOGY, CYTOLOGY AND UREASE TEST) FOR THE DETECTION OF HELICOBACTER PYLORI
Basrah Journal of Surgery,
2009, Volume 15, Issue 1, Pages 21-24
AbstractThis study aimed to assess the accuracy of histopathology, brush cytology, and
urease test in the diagnosis of Helicobacter pylori and to evaluate the effect of test
duration on the sensitivity and specificity of positive urease test for the detection of H.
Fifty patients [25 patients with gastritis group A and 25 patients with duodenal ulcer
group B] selected from those attending endoscopy unit for dyspeptic symptoms, were
enrolled in the study. Four endoscopic biopsies were taken from each patient. One
biopsy from each of antrum and body were obtained for urease test (Urease test was
read at 30 min, 1, 4 and 24 hour after biopsy insertion into the reagent), and one
biopsy from each of antrum and body were used for histopathological examination.
Antral brush cytology was taken also from each patient. The patients were considered
H. pylori positive when minimum concordances of 2 out of 3 tests (Histopathology,
brush cytology, and urease test) were positive.
Fourteen patients were positive for H. pylori in group A, in comparison to seventeen
patients in group B. The sensitivities of the histopathological examination, brush
cytology, and urease test at 24 hours in group (A) were 58%, 79%, and 93%
respectively. Corresponding figures for the specificity were 100%, 91%, and 46%
respectively. While in group (B) the sensitivities were 82%, 82%, and 100% and the
specificities were 100%, 100%, and 88% respectively.
It is concluded that among the invasive methods, the association of the urease test
with brush cytology constituted the best choice for confirming the diagnosis of H.
pylori, due to the high sensitivity of the urease test and high specificity of brush
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