The Diagnostic Accuracy of H. Pylori Culture and Rapid Urease Test in the Diagnosis of H.PYLORI Infection Keeping Histopathology as the Gold Standard

Abstract

Objective: The aim of this study was to determine the diagnostic accuracy of biopsy-based tests in the detection of Helicobacter Pylori infections keeping histopathology as a gold standard. Materials and Methods: This validation study was conducted from August 2018 to February 2019 at Khyber medical college, pathology department, Peshawar, and comprised biopsy samples of 87 patients obtained via endoscopy which was done at the gastrointestinal endoscopy department, Hayatabad medical complex (HMC). Patients with a history of prior antibiotics and PPIs were excluded from the study. Rapid urease test (RUT) and culture of gastroduodenal biopsies were validated against the histopathological examination of gastroduodenal mucosa. Results: Out of 87 patients, 57.47% (50/87) were male and 42.52% (37/87) were female patients with an age range of 18 -80 years and a mean age of 45 years. Endoscopic findings showed 64.36% (56/87) of patients with gastritis, duodenitis with 6.89% (6/87), peptic and duodenal ulcers with 22.98% (20/87), erosion with 4.59% (4/87) and adenocarcinoma of stomach with 2.29% (2/87). The sensitivity and specificity of culture were 45.45% and 90.7% respectively, while positive and negative predictive values were 62.5% and 83% respectively. The sensitivity and specificity of the rapid urease test (RUT) were 81.81% and 90% while positive and negative predictive values were 90% and 94% respectively. Conclusion: The sensitivity and specificity of the rapid urease test were 82 and 90% respectively, while that of culture was 45 and 91% respectively. Keys Words: Helicobacter Pylori, Gastritis, Rapid urease test, Adenocarcinoma