The influence of size or number of biopsies on rapid urease test results: a prospective evaluation

Decreased Prevalence of Helicobacter pylori Infection in Gastroesophageal Reflux Disease

“…It should be recognized that the retrospective nature of our study and lack of uniform testing for the presence of H. pylori among all patients may somewhat limit interpretation of our data. The sensitivity and specificity of the CLOtest has been reported to range from 80-95%, and 95-100%, respectively [36][37][38][39]. We used the CLOtest as the primary means of determining H. pylori status, since it is the diagnostic test most commonly used in clinical practice.…”

Can the 1.8 mm transnasal biopsy forceps instead of standard 2.2 mm alter rapid urease test and histological diagnosis?

“…Thus, these studies concluded that specimen size did not adversely affect CLO test yield, although a larger specimen shows a relatively higher positive rate on the CLO test. 4 The results that were different between two forceps might be associated with the presence of a low number of H. pylori in the tissue samples obtained with the 1.8 mm biopsy forceps due to smaller size of sample. First, the absolute number of H. pylori organisms obtained by the 1.8 mm biopsy forceps might be less compared with that of 2.2 mm forceps, although density was not different between the specimens.…”

“…These results conflict with previous studies. [4][5][6] Mahmoud et al reported that the sensitivity and specificity for the CLO test using 3.3 mm forceps were 92.1% and 95.5%, which were not different from the 88.0% and 98.8% using 1.8 mm forceps. 5 Similar results were reported for 2.2 mm and 3.3 mm forceps; Laine et al reported that the sensitivity for the CLO test using 2.2 mm forceps was 75% and that using 3.3 mm forceps was 80%.…”

“…Several studies have shown that specimen size does not adversely affect the diagnostic yield of a rapid urease test, when specimens are taken with 1.8 mm and 3.3 mm forceps, and with 2.2 mm and 3.3 mm forceps. [4][5][6] But, no direct comparative study has been conducted between 1.8 mm and 2.2 mm biopsy forceps. It was recently reported that increasing the number of gastric antral biopsy specimens significantly improves CLO test sensitivity.…”

Pediatric Issues Workshop Summary

“…A description of the available methods for diagnosis of H. pylori infection in children included descriptions of both invasive and noninvasive methodologies. Invasive methods involve the use of gastric biopsy and, for the most part, are performed no differently in children than in adults [34][35][36][37]. However, gastric mapping studies-including a determination of the appropriate number of biopsies required for the optimal evaluation of the presence of H. pylori infection in a child undergoing diagnostic upper endoscopy-have not been performed.…”