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5- EVALUATION OF ENDOSCOPY BASED METHODS (HISTOPATHOLOGY, CYTOLOGY AND UREASE TEST) FOR THE DETECTION OF HELICOBACTER PYLORI

Authors: Sawsan S Al-Haroon --- Sarkis K Strak --- Rafid Adil Abood
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2009 Volume: 15 Issue: 1 Pages: 21-24
Publisher: Basrah University جامعة البصرة

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Abstract

This study aimed to assess the accuracy of histopathology, brush cytology, andurease test in the diagnosis of Helicobacter pylori and to evaluate the effect of testduration on the sensitivity and specificity of positive urease test for the detection of H.pylori.Fifty patients [25 patients with gastritis group A and 25 patients with duodenal ulcergroup B] selected from those attending endoscopy unit for dyspeptic symptoms, wereenrolled in the study. Four endoscopic biopsies were taken from each patient. Onebiopsy from each of antrum and body were obtained for urease test (Urease test wasread at 30 min, 1, 4 and 24 hour after biopsy insertion into the reagent), and onebiopsy from each of antrum and body were used for histopathological examination.Antral brush cytology was taken also from each patient. The patients were consideredH. pylori positive when minimum concordances of 2 out of 3 tests (Histopathology,brush cytology, and urease test) were positive.Fourteen patients were positive for H. pylori in group A, in comparison to seventeenpatients in group B. The sensitivities of the histopathological examination, brushcytology, and urease test at 24 hours in group (A) were 58%, 79%, and 93%respectively. Corresponding figures for the specificity were 100%, 91%, and 46%respectively. While in group (B) the sensitivities were 82%, 82%, and 100% and thespecificities were 100%, 100%, and 88% respectively.It is concluded that among the invasive methods, the association of the urease testwith brush cytology constituted the best choice for confirming the diagnosis of H.pylori, due to the high sensitivity of the urease test and high specificity of brushcytology.

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