A limited amount of new information was published in the field of diagnosis and epidemiology of Helicobacter pylori this last year. Besides some improvement in current tests, it is interesting to note the attempts to identify severe disease, for example gastric cancer, by breath analysis using nanomaterialbased sensors. In contrast, the predictive value for gastric cancer and atrophy of pepsinogen determinations was found inadequate.Prevalence studies of H. pylori infection have been carried out in adults and children around the world in the general population but also in specific communities. The usual risk factors were found. In addition, a Japanese study highlighted the role of grandmothers in the familial transmission of H. pylori.A study showed that the infection may not always readily establish itself in children, given the number of transient infections observed. It was also noted that after eradication, a first-year relapse is likely to be a recurrence of the previous infection, while later on it is probably a reinfection with a new strain.
Diagnosis General Evaluation of Helicobacter pylori Diagnostic TestsTwo studies evaluating different diagnostic methods in specific settings concluded that histology was the most accurate test: Choi et al.[1] evaluated several tests for detecting H. pylori in Korean patients with bleeding (n = 157) and nonbleeding (n = 247) peptic ulcer. In bleeding patients, the sensitivity and specificity were 92.5 and 96% for histology, 40 and 100% for culture, 85 and 92% for rapid urease test (RUT), and 97 and 56% for serology, respectively. The sensitivities of culture and RUT in bleeding patients were significantly lower than in nonbleeding patients. By contrast, histology was reliable regardless of bleeding. Tian et al. [2] reported a meta-analysis evaluating H. pylori diagnostic methods in patients with partial gastrectomy. The pooled sensitivity and specificity were 93 and 85% for histology, 77 and 89% for urea breath test (UBT), and 79 and 94% for RUT, respectively. They concluded that histology was the most reliable test in this setting.
Invasive TestsEndoscopy A multicenter Japanese study evaluated the possibility to diagnose H. pylori by conventional endoscopy and chromoendoscopy using indigo carmine in comparison with histology performed according to the Sydney System, on 275 patients [3].Based on a set of indices including diffuse and spotted redness, enlarged and tortuous folds, and swelling, they achieved a sensitivity of 94% in the corpus and 88% in the antrum. However, the specificity was only 62 and 52%, respectively.
Rapid urease testMoon et al. [4] studied 240 patients to compare the efficacy of RUT performed on separate gastric antrum and corpus tissue specimens versus on combined specimens, using histology as a gold standard. Combining tissues prior to RUT increased the detection of H. pylori from 137 (64%) in separate specimens to 148 (69.2%)