Diagnosis of Helicobacter pylori infection in patients with atrophic gastritis: Comparison of histology, C-13-urea breath test, and serology

Background: Atrophic gastritis, a risk factor for gastric cancer, is a late consequences of Helicobacter pylori infection in approximately one-third o f the infected patients. It hits been suggested that gastric cancer would d evelop less frequently if H. pylori were eradicated. However, the prevalenc e of H. pylori infection may be underestimated in patients with atrophic ga stritis and intestinal metaplasia if only biopsy-based diagnostic methods w t used, Methods: We compared histology, C-13-urea breath test (C-13-UBT). a nd serology in H. pylori diagnostics in 50 male patients with atrophic corp us gastritis. Results: H. pylori was detected in 15 (30%) patients by histo logy and in 14 (28%) by C-13-UBT, is whereas increased serum antibody level s indicating H. pylori infection were found in 41 (82%) patients (P < 0.000 1 between serology and both histology and C-13-UBT). H. pylori infection wa s associated with atrophic corpus gastritis in 84% of the present patients (in one patient with normal antibody titres H. pylori was defined histologi cally). Conclusions: H. pylori infection would have been missed in most pat ients with atrophic gastritis without the analysis of H. pylori antibodies. Therefore, in patients with atrophic gastritis, the use of serology is enc ouraged in diagnosing H. pylori infection.