BIOPSY SITES SUITABLE FOR THE DIAGNOSIS OF HELICOBACTER-PYLORI INFECTION AND THE ASSESSMENT OF THE EXTENT OF ATROPHIC GASTRITIS

Objectives: We performed this study to determine which biopsy sites in the stomach are suitable for the diagnosis of Helicobacter pylori inf ection and the assessment of the extent of atrophic gastritis, Methods : Endoscopy was performed in 76 H, pylori-positive patients with histo logically confirmed chronic gastritis, Biopsies were taken from the fo llowing six sites: the lesser curvatures of the mid-antrum (site 1), t he angulus (site 2), the middle body (site 3), and the greater curvatu res of the mid-antrum (site 4), the angulus (site 5), and the middle b ody (site 6) of the stomach, The extent of atrophic gastritis was asse ssed endoscopically as well as histologically, and patients were class ified into five groups according to its extent. H, pylori status was a ssessed histo logically. The histological severity of inflammation, ac tivity, atrophy, and intestinal metaplasia was assessed according to t he Updated Sydney System. The grades of these items were compared amon g the six biopsy sites in each group of patients. Results: Site 6 was most reliable for the diagnosis of H, pylori infection, and site 4 was suitable for examining the status of H, pylori colonization in the an trum, Site 1, site 3, and site 6 were suitable for the assessment of t he extent of atrophic gastritis, Conclusions: Our results indicate tha t for an accurate diagnosis and assessment, biopsies should be taken f rom the following four sites: the lesser curvatures of the mid-antrum (site 1) and middle body (site 3), and the greater curvatures of the m id-antrum (site 4) and middle body (site 6) of the stomach. (C) 1998 b y Am. Coll. of Gastroenterology.