THE PREVALENCE OF HELICOBACTER PYLORI IN PATIENTS UNDERGOING ESOPHAGOGASTRODUODENOSCOPY: DIAGNOSTIC METHODS AND ASSOCIATED DISEASES

Ahmet Karatas; Hakk? Polat

Volume : VII, Issue : IV, April - 2018

THE PREVALENCE OF HELICOBACTER PYLORI IN PATIENTS UNDERGOING ESOPHAGOGASTRODUODENOSCOPY: DIAGNOSTIC METHODS AND ASSOCIATED DISEASES

Ahmet Karatas, Hakk Polat

Abstract :

Introduction and Objective

Helicobacter pylori infection is, one of the most common chronic bacterial infections in the world. Several invasive and non–invasive diagnostic methods are made use of to diagnose Helicobacter pylori (Hp). Using serological and histopathologic methods, this study investigated the frequency of Hp infections in patients undergoing esophagogastroduodenoscopy (=EGD), its associations with the age and occupational groups, and with the gastroduodenal diseases. In addition, the sensitivity, specificity, and the positive (PPV) and negative predictive values (NPV) of these methods were studied as well.

Material and Method

Hp positivity, the diagnostic methods, and associated diseases were studied in 302 cases, who applied to the endoscopy department of Necmettin Erbakan University, Internal Medicine and General Surgery due to various indications and who underwent EGD. Biopsy specimens were collected from the antral mucosa of the stomach from all patients. These samples were stained with hematoxylin–eosin (HE) stain and were examined histopathologically. Hyperemia, edema, atrophy, erosion, ulcer, and other pathologic findings identified during the EDG were recorded. Then, the type of the lesion, positivity for the bacteria, and association of the bacteria with the epithelial tissue were examined. Among the tissue samples collected by biopsy, a separate tissue sample per patient was used to perform the urease test. Hp specific IgG and IgA antibodies were investigated by the ELISA method.

Results

The mean age of the patients was 47.3�16.1. 42% of the patients were males and 58% were females. The distribution of the cases according to their EGD results was as follows: Gastritis 38.4%, adenocarcinoma of the stomach 5%, duodenal ulcer 5.6%, stomach ulcer 2.3%, the patient group with unclassified diagnoses 44.7%, and the patients with normal findings 4%. IgA was positive in 53% of the cases. Among all diagnosis groups according to their EGD results, the highest rate of positivity of IgA was found in 66.7% of the adenocarcinoma cases. Hp was identified in 67.5% of the cases either with the urease test or with the histologic methods. The concordance of histopathology and urease test was 74%. Both were positive in 42% of the cases and both were negative in 42% of the cases. The diagnostic concordance of endoscopic and pathologic examinations was 76.8%.

Conclusion

Identification Hp is quite important as it is considered to be an effective pathogen for the development of stomach cancer or preceding lesions. Our study demonstrated a high rate of positive correlation between the endoscopic view and pathologic diagnosis. Therefore, referring the patients with upper GIS findings for endoscopic imaging methods is important both for the early diagnosis and in determining the treatment strategies. Endoscopic examination is an irreplaceable cornerstone for the diagnosis of Hp.