Thomas Bazin1, Arouna Nchare Mfondi2, Catherine Julie3, Jean-François Émile3,4, Josette Raymond5, Dominique Lamarque4. 1. Université de Bordeaux, INRA, EA 3671, CHU Bordeaux, Bordeaux, France. 2. Yaounde Emergency Center, Yaounde Hospital, Yaounde Hospital, Cameroon. 3. Pathology Department, Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, France. 4. UVSQ, EA 4340, AP-HP, 92104, Boulogne-Billancourt, France. 5. Bacteriology, University of Paris-Descartes, Cochin Hospital, Paris, France.
Abstract
BACKGROUND: Helicobacter pylori detection by standard methods may be altered by proton pump inhibitor (PPI) use. However, some patients cannot or should not interrupt PPI use before undergoing testing for H. pylori. Polymerase chain reaction (PCR) could allow more reliable H. pylori detection even in patients taking PPIs. OBJECTIVE: The aim of our study is to compare the H. pylori infection diagnostic value of histological examination without and with immunohistochemical staining, bacterial culture and PCR, in PPI-treated vs untreated patients. METHODS: Patients undergoing a gastric endoscopy for upper digestive symptoms were included. Gastric biopsy samples were obtained. The impact of taking PPI on the diagnostic performance of the different methods was studied. PCR results were confirmed by sequencing the glmM gene. RESULTS: A total of 497 patients were included, of whom 192 were H. pylori positive. Fifty-two patients received PPIs during the 14 days preceding the endoscopy while 140 did not. All methods had lower sensitivity than PCR, in all cases (PPI treatment or not). PPI use did not change significantly the methods' sensitivities. CONCLUSION: The PCR method showed the best performance for the detection of H. pylori in gastric samples, whether or not patients received previous PPI treatment. This diagnosis test could become a new gold-standard test, especially in patients undergoing PPI treatment.
BACKGROUND: Helicobacter pylori detection by standard methods may be altered by proton pump inhibitor (PPI) use. However, some patients cannot or should not interrupt PPI use before undergoing testing for H. pylori. Polymerase chain reaction (PCR) could allow more reliable H. pylori detection even in patients taking PPIs. OBJECTIVE: The aim of our study is to compare the H. pylori infection diagnostic value of histological examination without and with immunohistochemical staining, bacterial culture and PCR, in PPI-treated vs untreated patients. METHODS: Patients undergoing a gastric endoscopy for upper digestive symptoms were included. Gastric biopsy samples were obtained. The impact of taking PPI on the diagnostic performance of the different methods was studied. PCR results were confirmed by sequencing the glmM gene. RESULTS: A total of 497 patients were included, of whom 192 were H. pylori positive. Fifty-two patients received PPIs during the 14 days preceding the endoscopy while 140 did not. All methods had lower sensitivity than PCR, in all cases (PPI treatment or not). PPI use did not change significantly the methods' sensitivities. CONCLUSION: The PCR method showed the best performance for the detection of H. pylori in gastric samples, whether or not patients received previous PPI treatment. This diagnosis test could become a new gold-standard test, especially in patients undergoing PPI treatment.
Authors: G Manes; A Balzano; G Iaquinto; C Ricci; M M Piccirillo; N Giardullo; A Todisco; M Lioniello; D Vaira Journal: Aliment Pharmacol Ther Date: 2001-01 Impact factor: 8.171
Authors: Luigi Gatta; Nimish Vakil; Chiara Ricci; John F Osborn; Andrea Tampieri; Federico Perna; Mario Miglioli; Dino Vaira Journal: Am J Gastroenterol Date: 2004-05 Impact factor: 10.864