A Comparison Between Histology and Rapid Urease Test in the Diagnosis of Helicobacter Pylori in Gastric Biopsies: A Systematic Review

Urgessa, Neway A; Geethakumari, Prabhitha; Kampa, Prathima; Parchuri, Rakesh; Bhandari, Renu; Alnasser, Ali R; Akram, Aqsa; Kar, Saikat; Osman, Fatema; Mashat, Ghadi D; Tran, Hadrian Hoang-Vu; Franchini, Ana P Arcia

doi:10.7759/cureus.39360

Cited by 5 publications

(5 citation statements)

References 23 publications

(46 reference statements)

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“…Sensitivity and specificity are essential indicators of test accuracy and allow healthcare providers to determine the appropriateness of the diagnostic tool aiding in decision-making and improving healthcare for patients [ 23 ]. It is critical to use at least two diagnostic tests with high sensitivity and specificity based on the clinical situation to achieve an accurate diagnosis of the pathogen [ 24 , 25 ]. Therefore, the sensitivity, specificity, and limitations of the H. pylori detection test, which plays a critical role in the accurate diagnosis and assessment of the presence of the bacteria, are presented in Table 2 .…”

Section: Methods For Detecting H Pylorimentioning

confidence: 99%

“…It is considered the gold standard for the direct diagnosis of H. pylori . However, the accuracy of this diagnostic method depends on the load of microorganisms in the sample and the site of the gastric mucosa in which the biopsy was collected [ 14 , 25 ]. Histological diagnosis is generally confirmed through four biopsies (two from the curves and two from the body of the stomach) [ 1 ].…”

Section: Methods For Detecting H Pylorimentioning

confidence: 99%

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Diagnostic Methods for <i>Helicobacter pylori</i>

Costa,

das Graças Carvalho,

La Guárdia Custódio Pereira

et al. 2024

Med Princ Pract

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H. pylori infection is a significant global health concern. It cannot be diagnosed based solely on the patient's medical history and symptoms, and laboratory and imaging tests are often required to confirm the diagnosis. Both non-invasive and invasive methods are available for diagnosing H. pylori infection, including conventional and advanced detection techniques. It is not uncommon for patients to present with false-negative results due to the use of inadequate investigation methodologies, which prevents the adoption of appropriate clinical management. Thus, an analysis of the literature regarding the methods of diagnosis of H. pylori, with its advantages and disadvantages, is necessary. Publications in specialized scientific journals will undoubtedly contribute to facilitating access by professionals interested in the topic providing greater knowledge and potentially clinically useful guidance. In this review, the authors have sought to analyze and summarize the invasive and non-invasive methods, their applications, limitations, and the conditions that affect the sensitivity of the tests used for diagnosing H. pylori, an essential step for the successful treatment of this infection. It is essential to treat all patients infected with H. pylori. This represents a significant change in the approach, as previously treatment was recommended only for patients showing symptoms of infection. Therefore, it is crucial to understand the limitations of traditional diagnostic methods and help raise awareness among healthcare professionals about the latest advances in diagnosing this important bacterium.

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Section: Methods For Detecting H Pylorimentioning

confidence: 99%

Section: Methods For Detecting H Pylorimentioning

confidence: 99%

Diagnostic Methods for <i>Helicobacter pylori</i>

Costa,

das Graças Carvalho,

La Guárdia Custódio Pereira

et al. 2024

Med Princ Pract

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“…All of the patients were tested for H. pylori using at least one of the following methods: histological method, rapid urease test, serological test (H. pylori IgG), determination of monoclonal antigen in feces, 13 C urease breath test [ 10 , 11 ], as well as data on the presence of infection in medical records. All respondents of the study on the prevalence of H. pylori and precancerous changes in Moscow residents underwent a 13 C urease breath test and an assessment of antibodies to H. pylori IgG (Gastropanel, Biohit).…”

Section: Methodsmentioning

confidence: 99%

The Impact of the Angulus Biopsy on the Detection of Staging and the Grading of Chronic Gastritis

Khomeriki,

Bordin,

Khomeriki

et al. 2023

Diagnostics

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There is a generally recognized need for a morphological assessment of the individual risk of developing gastric cancer in a patient with chronic gastritis, according to the OLGA system (Operative Link for Gastritis Assessment). At the same time, the role of assessing the biopsy from the incisura angularis remains controversial. The aim of our study was to assess the value of incisura angularis biopsy in staging gastritis according to the OLGA system by examining the atrophic and inflammatory changes in the antrum, incisura angularis, and body. Materials and Methods: A total of 718 patients (576 women and 142 men) aged 20 to 84 years were examined. Most of the patients were in the age group of 50 to 70 years (54.6%). Depending on the detection of H. pylori and autoimmune gastritis markers, all patients were divided into three groups. The first group included 380 patients with H. pylori gastritis without signs of autoimmune gastritis. The second group consisted of 209 patients with autoimmune gastritis, in whom no infection was detected during the examination, and there were no indications of H. pylori eradication. The third group consisted of 129 patients with chronic gastritis of combined etiology (autoimmune and H. pylori). Endoscopy biopsies were taken according to the updated Sydney System. Histological assessments of the grade and the stage of gastritis were carried out according to the standard OLGA-based protocol. Then, the same assessments were evaluated without taking into account histological changes in the incisura angularis. Results: When assessing the severity of inflammatory changes in the gastric mucosa according to the OLGA system, grade II (72.3%) was most often detected in all groups of patients. A severe degree of activity of chronic gastritis was most often observed in the group of patients with H. pylori gastritis (6.1%). These indicators practically did not change if the assessment did not take the angulus biopsy into account. When assessing the severity of atrophy of the glands in the gastric mucosa in patients of the first group, mild stages of atrophy prevailed. Without taking into account the angulus biopsy, a decrease in the stage of atrophy was observed in 27 cases (7.11%), and in only 4 cases did stage IV change to stage III, while in 23 cases, discrepancies were noted only within groups with a mild stage of atrophy. There were no transitions from stage III to stage II. In the group of patients with autoimmune gastritis, pronounced stages of atrophy prevailed—in more than 77%. Without taking into account the angulus biopsy, a decrease in the stage of atrophy was observed in eight cases (3.83%), and in three (1.4%) patients, stage III was changed to stage II. In the group of patients with combined etiology (autoimmune + H. pylori), severe stages of atrophy also prevailed (70.5%). A decrease in the stage of atrophy without taking into account the angulus biopsy was only observed in three patients (2.32%), of which two cases concerned patients with mild stages of atrophy. Thus, in general, severe stages of atrophy of the gastric mucosa (stages III and IV according to the OLGA staging system) were detected in 313 patients (43.59%). If the assessment of the atrophy stage did not take into account changes in the angulus biopsy, then severe stages of atrophy (III and IV according to OLGA) were detected in 310 patients (43.17%). In total, changes in the assessment of the atrophy stage occurred in 38 patients (5.29%), and this was more often observed in patients with stages I and II of atrophy. Conclusions: Accounting for histological changes in the incisura angularis does not significantly affect the assessment of the grade and stage of chronic gastritis according to the OLGA system, regardless of the etiology of atrophic gastritis.

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“…Invasive tests relying on endoscopic procedures include histopathology, rapid urease test, and polymerase chain reaction. These invasive tests exhibit sensitivity and specificity levels exceeding 90% [10]. Therefore, the aim of the present study was to identify the characteristics of endoscopic gastric biopsy among symptomatic Saudi patients with H. pylori infection and to identify any preneoplastic changes.…”

Section: Introductionmentioning

confidence: 97%

Histopathological Findings in Adult Patients With Dyspepsia and Their Association With Helicobacter pylori Infection

Ahmed,

Mohammed,

Alghamdi

et al. 2023

Cureus

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Background: Helicobacter pylori infection is prevalent among Saudi adults and has been linked to gastric cancer and other tumor-like conditions. We aimed to explore the pathological characteristics of endoscopic gastric biopsies among symptomatic adult Saudi patients and their relation to H. pylori infection.Results: Among 151 gastric biopsies, gastritis was detected in 97 (64.2%) cases, chronic active gastritis in 26 patients (17.2%), duodenitis in 20 (13.2%) patients, and total metaplasia in 14 (9.3%) patients. H. pylori was detected in 83 cases (55%), with a recurrence or reinfection rate of 9.8%. The patients with H. pylori infection were considerably young (median age: 34 (IQR: 15) vs. 35.5 (IQR: 11), p = 0.024) and had a low frequency of epigastric pain (78.3% vs. 91.2%, p = 0.031), reflux/regurgitation (7.2% vs. 20.6%, p = 0.016), and dysphagia (4.85% vs. 14.7%, p = 0.037). However, they exhibited a higher incidence of chronic active gastritis (96.2% vs. 3.8%, p < 0.001) and intestinal metaplasia (85.7% vs. 14.3%, p = 0.015). Young age (OR = 1.09, 95% CI = 1.02-1.16, p = 0.011) and H. pylori infection (OR = 30.85, 95% CI = 3.26-291.60, p = 0.003) were identified as a positive predictor of intestinal metaplasia while heartburn (OR = 0.08, 95% CI = 0.01-0.58, p = 0.012) was a negative predictor. Conclusion:H. pylori infection is prevalent among Saudi adults experiencing upper gastrointestinal symptoms and is associated with intestinal metaplasia. Infection rate and intestinal metaplasia were higher in patients with milder symptoms. Therefore, screening for H. pylori is highly recommended for Saudi individuals with upper gastrointestinal symptoms. Old age and H. pylori infection were identified as positive predictors of intestinal metaplasia, emphasizing the importance of early detection and management of H. pylori infection in the Saudi population.

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A Comparison Between Histology and Rapid Urease Test in the Diagnosis of Helicobacter Pylori in Gastric Biopsies: A Systematic Review

Cited by 5 publications

References 23 publications

Diagnostic Methods for <i>Helicobacter pylori</i>

Diagnostic Methods for <i>Helicobacter pylori</i>

The Impact of the Angulus Biopsy on the Detection of Staging and the Grading of Chronic Gastritis

Histopathological Findings in Adult Patients With Dyspepsia and Their Association With Helicobacter pylori Infection

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