The importance of increasing the number of gastric biopsies in the diagnosis of Helicobacter pylori

BACKGROUND/AIMS: The role of Helicobacter pylori in various gastroduodenal diseases is universally accepted. In this study, we aimed to determine the proper number and sites of the gastric biopsies in order to achieve the hig hest diagnostic yield through the use of a urease test and histopathology. We also compared the histological findings encountered in patients who had Helicobacter pylori (H. pylori) colonization. METHODOLOGY: Fifty patients referred for upper gastrointestinal endoscopy f or dyspeptic complaints were included in the study. Our mapping protocol in cluded 2 biopsies from antrum and 2 biopsies from corpus. We obtained 2 bio psies from each biopsy site for urease test and histopathological assessmen t. Golden standard positivity for the presence of H. pylori colonization wa s defined as concomitantly positive urease test and histologically detected bacteria found at the same biopsy site. RESULTS: Forty-three patients had H, pylori colonization. Colonization rate s of H. pylori, sensitivities of urease testing, and histopathology in 4 bi opsy sites were not statistically different. Sensitivity of urease testing was 81.4% for 1 biopsy and 100% for 4 cumulative biopsies. Sensitivities of histological assessment were 93% and 100% for 1 and 4 biopsies, respective ly. CONCLUSIONS: Results of this study suggest that 2 biopsies for urease testi ng and 1 biopsy for histopathology obtained from the antrum or corpus of th e stomach were sufficient to obtain the highest statistically significant d iagnostic sensitivity.