High recurrence rates of Helicobacter pylori infection can be related to false-positive histologies
| Autor: | László Herszényi, Zsolt Tulassay, Márk Juhász, Zsófia Vesza |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Helicobacter pylori infection
medicine.medical_specialty Physiology Biopsy H&E stain Context (language use) Gastroenterology Giemsa stain Helicobacter Infections Recurrence Internal medicine medicine Humans Urea False Positive Reactions Prospective cohort study Breath test Carbon Isotopes medicine.diagnostic_test Helicobacter pylori business.industry Stomach Hepatology Breath Tests business |
| Zdroj: | Digestive diseases and sciences. 53(9) |
| ISSN: | 0163-2116 |
| Popis: | Sirs, in issue 53 (May 2008) Niv et al. published their paper on the high reccurence and infection rate of H. pylori in Israeli adults [1]. The authors relied exclusively on C-urea breath test (C-UBT) for the clarification of H. pylori status. In this short comment, we would like to confirm the validity of this diagnostic strategy, underlining the superiority of C-UBT over histology in terms of diagnostic accuracy. In our study, antrum and corpus biopsies of 1,726 patients, taken between 1994 and 2006, were reviewed retrospectively in order to evaluate the H. pylori status that was determined with hematoxylin eosin and confirmed with Giemsa staining. The H. pylori positivity rate was 666/1,726 (39%). Of these 666 H. pylori-positive patients, 149 patients had negative control biopsy after eradication; at follow-up, 13/149 patients developed H. pylori positivity (reinfection) subsequently. The remaining 136 patients were called in for C-UBT; 3 of the 35 participating patients proved to have acquired H. pylori reinfection. Taken together, we have been able to evaluate the current post-eradication H. pylori status of 48 patients, and reinfection was confirmed in 16 of the cases (33%). This rate is markedly higher than results previously published in literature in the same context. We suggest that the number of true reinfection cases is lower, and failure in methodology is suspected to be responsible for our higher recurrence rate. Considering that C-UBT is being regularly validated, we are now planning a prospective study, with histologies being interpreted by two independent pathologists blinded to the clinical parameters in order to obtain a clear-cut picture. Our aim was to draw attention to the possible shortcomings of involving several histologists in the diagnostic work-up of gastric biopsy samples instead of applying exclusively skilled pathologists, thereby reducing the rate of false-positive H. pylori results. |
| Databáze: | OpenAIRE |
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