Usefulness of brushing urease test for diagnosis of Helicobacter pylori infection

Background and Aims. Gastric brushing cytology is an accurate technique for rapidly detecting Helicobacter pylori infection, bur it is not routinely e mployed since the presence of personnel experienced in this field, is neces sary in the endoscopy suite. To evaluate the diagnostic usefulness of rapid urease test carried out on cytological brushing. Patients. A total of 143 consecutive patients with suspected Helicobacter p ylori infection, referred for elective gastroscopy. Methods. For each patient, 2 brushings were carried out and 4 biopsies were taken from antral mucosa during gastroscopy. The former brushing was smear ed on a slide, and stained by a rapid staining set for blood smears. The la tter was used for rapid urease test, by shaking the brush into the urea bro th. Two biopsies were used for rapid urease rest and two for histologic exa mination. Histology, was considered as the gold standard. Results. Of 143 patients, 73 were diagnosed as Helicobacter pylori infected using histology. Six brushing slides were in adequate due to insufficient cytology material. Biopsy-rapid urease test and brushing-rapid urease test had similar sensitivity (87.3% vs 83.5%), specificity (98.4% vs 96.8%) and overall accuracy (92.3% vs 89.5%). In 62 Helicobacter pylori infected patie nts, both rapid urease test techniques were positive. Brushing-rapid urease test became positive in a sig nificantly shorter rime than biopsy-rapid ur ease test (22 +/- 54 minutes vs 39 +/- 63 minutes; p < 0.01). Conclusions. Brushing-rapid urease test is as accurate as biopsy-rapid urea se test in detecting Helicobacter pylori infection, but it is significantly faster. Special care should be taken to carry out brushing adequately, to minimize the occurrence of false negatives.