Assessing the Reliability of PCR, Microbiological and Histologic Methods in Detecting Helicobacter pylori in Gastric Biopsies

Background: Helicobacter pylori is currently recognized as one of the most common chronic bacterial infections worldwide. It is the cause of gastritis, peptic ulcer, gastric cancers and gastric malt lymphoma. Reliable methods of detecting this bacterium will help in successful eradication and/or reduction in the risk of gastric carcinoma.

Methods: Upper endoscopy was performed on 80 patients referred for endoscopy and gastric biopsies taken from the antrum and tested by PCR, histology, urease, ELISA and culture using standard techniques.

Results: The yield of Helicobacter pylori by different diagnostic methods in the study indicated that Urease had the highest positivity of 91.25% while culture was the least with 1.25%. PCR of 16S rRNA gene was the gold standard. Immunohistochemistry and SYBR Green had almost perfect agreement with PCR (kappa value=0.840; p<0.001, kappavalue= 0.88; p=0.001 respectively), Giemsa had a substantial agreement with PCR (kappa=0.770; p<0.001); ELISA had a fair agreement (kappa-value=0.220; p=0.002) while culture had a slight agreement (kappa-value=0.057; p=0.120).

Conclusion: All the test methods used in the study had a significant agreement with PCR which was used as the gold standard except ELISA and culture.


Yaji Mnena E, Nna Emmanuel and Ega RAI

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