BRUSH CYTOLOGY - A RELIABLE METHOD TO DETECT HELICOBACTER-PYLORI

This study was conducted to verify the reliability of brush cytology i n detecting Helicobacter pylori in an unselected group of patients wit h duodenal ulcer (DU) and nonulcer dyspepsia (NUD). Endoscopy was perf ormed on 416 consecutive patients: group A, 94 with active DU; group B , 176 patients with DU after omeprazole (n = 78), ranitidine (n = 43), or triple anti-H. pylori therapy (n = 55); and group C, 146 patients with NUD. During endoscopy, the gastric mucosa was brushed and two bio psy samples from the antrum and body were obtained for histology. In 6 5 patients, culture of the brush-collected materials also was performe d as was that from of biopsy samples. The overall frequency of H. pylo ri presence detected by brush cytology was significantly higher compar ed with that of histology (p < 0.001), particularly in group A (p < 0. 05), group C (p < 0.05), and in patients with DU after omeprazole trea tment (p < 0.01), but not in patients with DU after ranitidine or anti -H. pylori treatment. The overall frequency of H. pylori-positive cult ures from the brush-collected material was higher compared with cultur es from the biopsy samples (38.5% vs. 24.6%), particularly in the NUD group (32.6% vs. 16.3%). Brush cytology is more sensitive than histolo gy, besides being faster and cheaper, for the assessment of H. pylori infection, particularly when the density of the bacteria is low.