Evaluation of Invasive and Non-Invasive Methods for the Diagnosis of H. pylori in Dyspepsia Patients

Abstract

Background: H. pylori has been established as the major causative agent of chronic gastritis, and represents the main etiological cause of other gastroduodenal diseases such as peptic ulceration, gastric lymphoma, and gastric cancer. Therefore, screening and treatment of the bacterium is an important strategy for preventing gastric cancer. Objective: To compare some invasive classical histological tests to non-invasive serological antibody and stool antigen tests for the diagnosis of H. pylori infections. Patients and Methods:The study population comprised of 171 patients with symptoms of dyspepsia and other gastritis related symptoms. Three biopsy specimens were taken and collected from the stomach and sent for histopathologic study. H and E staining and modified Giemsa staining were performed on tissue sections of each case. Serology antibody and Stool antigen tests were also used as nan-invasive tests in this study. Results: Four tests had been done to detect the presence of H. pylori Bacteria. The mean age (+ SD) of the studied sample was 43.8 + 14.7 years, ranging from 20 to 74 years. The median was 44 years. The total agreement between the serum Ab test and the stool Ag test was 88.3%. Significant differences were detected between the two tests (p < 0.001). It is evident that the serum Ab test is highly sensitive (sensitivity = 98.4%), but the Predictive value positive (76.3%) was not so high. The Giemsa test was highly specific (specificity = 98.2%), and highly sensitive (sensitivity = 93.5%). Conclusion: The main advantage of histopathology tests is not only restricted to detection purpose, it also can detect any abnormalities of gastric mucosa by bacteria such as peptic ulcer bleeding, atrophic gastritis, intestinal metaplasia, and gastric cancer. The modified Giemsa staining method could be used as a method of choice for the detection of H. pylori due to its sensitivity, simplicity and consistency.

Evaluation of Better Staining Method among Hematoxylin and Eosin, Giemsa and Periodic Acid Schiff-Alcian Blue for the Detection of Helicobacter pylori in Gastric Biopsies

“…Giemsa stain is a simple, rapid and inexpensive stain that has good sensitivity, specificity and consistency in the detection of H. pylori infection ( 13 , 27 , 33 , 34 ). Therefore, it is routinely used in some institutions.…”

“…Therefore, it is routinely used in some institutions. According to many scientific papers, Giemsa stain is superior to H&E in the detection of H. pylori ( 13 , 27 , 30 , 33 , 34 ). Based on our findings, the sensitivity of Giemsa stain in the detection of H. pylori is 93.33% while its specificity is 100%, which makes it better than H&E and PAS-AB stains.…”

Comparison of invasive histological and molecular methods in the diagnosis of Helicobacter pylori from gastric biopsies of Sudanese patients: a cross-sectional study

“…1,8 Clinically, a variety of various invasive techniques (requiring endoscopy and biopsy which include, culture, histological examination, and rapid urease test, CLO (Campylobacter like organism) test, smear examination, and molecular studies) or noninvasive techniques (including serology, respiratory urea breath test, or the detection of fecal antigen) are often performed to detect H. pylori infection. [9][10][11] The sensitivity of any of those techniques in detecting H. pylori relays on how the density of the bacterial cells within the specimens taken by biopsy (recent use of disease-related medications, specifically antibiotics and protonpump inhibitors (PPI) can reduce the density of the cells), pathologist expertise, also the type and quality of the stain used for detection purposes. 10 Many studies reported that the gold standard method for the diagnosis is the detection of H. pylori in biopsy material.…”

“…[9][10][11] The sensitivity of any of those techniques in detecting H. pylori relays on how the density of the bacterial cells within the specimens taken by biopsy (recent use of disease-related medications, specifically antibiotics and protonpump inhibitors (PPI) can reduce the density of the cells), pathologist expertise, also the type and quality of the stain used for detection purposes. 10 Many studies reported that the gold standard method for the diagnosis is the detection of H. pylori in biopsy material. 12,13 Currently, many clinical laboratories use urease tests and histological analysis as a gold standard approach.…”

Evaluation of Invasive and Molecular Methods in the Diagnosis of Helicobacter Pylori From Gastric Biopsies of Sudanese Patients. A Comparative Approach

“…Moreover, H. pylori may be implicated in several extra-gastric diseases such as iron de ciency anemia, idiopathic thrombocytopenic purpura, and several dermatological disorders (Chmiela et al, 2017, Kodaman et al, 2014, Testerman and Morris, 2014. Its distribution is worldwide and affects more than 90% of the world population, but it is more common in developing countries with the highest prevalence found in Africa (Idris et al, 2021, Zamani et al, 2018, probably due to the possible transmission through fecal-oral route and the unsafe sanitation conditions in these countries (Eldeen et al, 2019, Nevoa et al, 2017.Clinically, a variety of various invasive techniques (requiring endoscopy and biopsy which include, culture, histological examination, and rapid urease test, CLO (Campylobacter like organism) test, smear examination, and molecular studies) or noninvasive techniques (including serology, respiratory urea breath test, or the detection of fecal antigen) are often performed to detect H. pylori infection (Akanda and Rahman, 2011, Mawlood et al, 2019, Wang et al, 2015. The sensitivity of any of those techniques in detecting H. pylori relays on how the density of the bacterial cells within the specimens taken by biopsy (recent use of disease related medications speci cally antibiotics and proton-pump inhibitors can reduce the density of the cells), pathologist expertise, also the type and quality of the stain used for detection purposes (Mawlood et al, 2019).…”