Open Access Research article

Additional corpus biopsy enhances the detection of Helicobacter pylori infection in a background of gastritis with atrophy

Hung-Chieh Lan13, Tseng-Shing Chen1*, Anna Fen-Yau Li2, Full-Young Chang1 and Han-Chieh Lin1

Author Affiliations

1 Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital and National Yang-Ming University, #201 Shih-Pai Road, Section 2, Taipei, Taiwan, ROC

2 Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan, ROC

3 Division of General Medicine, Department of Medicine, Taipei City Hospital, Taipei, Taiwan, ROC

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BMC Gastroenterology 2012, 12:182  doi:10.1186/1471-230X-12-182

Published: 29 December 2012

Abstract

Background

The best sites for biopsy-based tests to evaluate H. pylori infection in gastritis with atrophy are not well known. This study aimed to evaluate the site and sensitivity of biopsy-based tests in terms of degree of gastritis with atrophy.

Methods

One hundred and sixty-four (164) uninvestigated dyspepsia patients were enrolled. Biopsy-based tests (i.e., culture, histology Giemsa stain and rapid urease test) and non-invasive tests (anti-H. pylori IgG) were performed. The gold standard of H. pylori infection was defined according to previous criteria. The sensitivity, specificity, positive predictive rate and negative predictive rate of biopsy-based tests at the gastric antrum and body were calculated in terms of degree of gastritis with atrophy.

Results

The prevalence rate of H. pylori infection in the 164 patients was 63.4%. Gastritis with atrophy was significantly higher at the antrum than at the body (76% vs. 31%; p<0.001). The sensitivity of biopsy-based test decreased when the degree of gastritis with atrophy increased regardless of biopsy site (for normal, mild, moderate, and severe gastritis with atrophy, the sensitivity of histology Giemsa stain was 100%, 100%, 88%, and 66%, respectively, and 100%, 97%, 91%, and 66%, respectively, for rapid urease test). In moderate to severe antrum or body gastritis with atrophy, additional corpus biopsy resulted in increased sensitivity to 16.67% compare to single antrum biopsy.

Conclusions

In moderate to severe gastritis with atrophy, biopsy-based test should include the corpus for avoiding false negative results.

Keywords:
Gastritis with atrophy; Biopsy-based test; Biopsy site; Helicobacter pylori