The Comparison of Biopsy Sites Measured by Rapid Urease Test for Diagnosed of Helicobacter pylori Infection Between a Population with Gastric and Duodenal Ulcers

Abstract

AIM: The aim of this study was to compare of biopsy sites for rapid urease test diagnosed of H. pylori infection between a population with gastric and duodenal ulcers.

METHODS: Patients received upper gastrointestinal endoscopy due to epigastria and diagnosed as peptic ulcer disease between January and July 2009 were collected. Biopsies were obtained from four sites on the antrum, corpus, fundus and angularis. The specimens all taken for the CLO rapid urease test were observed at 2, 12 and 24 hours.

RESULTS: Among all 109 patients enrolled, the positive rapid urease test was noted in 14 (45.2%) and 52 (66.7%) among those with gastric and duodenal ulcers. Gastric ulcers cases had the same positive rate (85.7%) at different biopsy sites. Duodenal ulcers cases had the significantly low positive rate at fundus (80.8%). The test sensitivity was increased if two biopsies instead of only one. To gastric ulcer patients, two biopsies with one from antrum, were suitable. To duodenal ulcer patients, one biopsy from antrum, or two biopsies with one from antrum, were acceptable to the accurate diagnosis of H. pylori infection.

CONCLUSION:  H. pylori was predominantly antral in the patients with duodenal ulcers, and equal distribution over all stomach, though mildly increased corpus colonization density, in those with gastric ulcers. Two biopsies with one from antrum were encouraged to minimize the false negative rate of rapid urease test.