Value of Additional Corpus Biopsy for Diagnosis of Helicobacter Pylori in Atrophic Gastritis

AbdEl-Latif M, HafrEl-Batin E, Shahin R, Shawqy A, Arafa M, Ghafar Saleh AA and Husien AM

Department of Surgery, Mansoura University Hospital, Egypt
Department of Pathology, Mansoura University Hospital, Egypt
Department of Clinical Pathology, Benha University Hospital, Egypt
Department Of Internal Medicine, Gastroenterology unit, Mansoura University Hospital, Egypt
Department of Pathology, Mansoura University Hospital, Egypt
Department of Internal Medicine, Gastroenterology Unit, Mansoura University Hospital, Egypt
Department of Internal Medicine, Benha University Hospital, Egypt

^*Correspondance to: AbdEl-latif M 

 PDF  Full Text DOI: 10.25107/2474-1647.1093

Abstract

Background: There is still debate on the best sites for biopsy- based tests of Helicobacter pylori infection in patients with gastritis. This study was designed to determine if it is important to add corpus biopsies to the routine antral ones for identification of H. pylori, especially in case of gastric atrophy and/or intestinal metaplasia.Methods: This is a prospective multicenter study (Mansura University Hospital-Egypt, Benha University hospital–Egypt, Hafer Al Batin Central Hospital, KSA), including three hundred and twenty eight patients with gastritis from June 2014 through Dec. 2015. Endoscopic mucosal biopsies from the gastric antrum and corpus were submitted to histological examination according to updated Sydney system for detection of H. pylori and to evaluate the degree of gastritis with or without atrophy and intestinal metaplasia using both routine H&E and modified Giemsa stained tissue sections.Results: In the study period, a total 328 consecutive patients underwent upper gastrointestinal endoscopy for different reasons. The mean age of the patients was 39+12 years; 183 (55.7%) were women. H pylori was found positive in 193 (58.8%) of the patients. Combined antral and corpus biopsies increased the result by 20.8% compared to antral biopsies alone and 4.5% compared to corpus biopsies alone. 20.8% of patients infected with H pylori would have been misdiagnosed if testing from antrum alone and not combined with corpus. Atrophy and intestinal metaplasia were found in 101(30.8%) and 17(5.2%) of our patients, respectively. Atrophic gastritis was significantly more often in the antrum than the corpus (29.2 vs. 11.9%, respectively, p< 0.05). Patients with only positive corpus biopsies showed more incidences of both atrophy and intestinal metaplasia. Detection rates of H pylori decreased as more as atrophy increased regardless of biopsy site. Sensitivity of antrum biopsies alone, 65% compared to 92.5% in corpus alone or 100% if combination of both.Conclusion: This study clarified that additional gastric corpus biopsy to the antral one increases the sensitivity to detect H pylori infection especially if associated with gastric atrophy.

Keywords

Gastric atrophy; Sydneysystem; H pylori and Gastritis

Cite the article

AbdEl-Latif M, HafrEl-Batin E, Shahin R, Shawqy A, Arafa M, Ghafar Saleh AA, et al. Value of Additional Corpus Biopsy for Diagnosis of Helicobacter Pylori in Atrophic Gastritis. Clin Surg. 2016; 1: 1093.