CLO (TM) vs histology: optimal numbers and site of gastric biopsies to diagnose Helicobacter pylori

Objective To determine the optimal numbers and sites of biopsies required f or diagnosis of Helicobacter pylori by using the CLOtest and comparing the results with those of a routine histological assessment in a district gener al hospital (DGH) setting. Methods A prospective study comparing the sensitivity of the CLOtest contai ning one antral (CLO 1), two antral (CLO 2) and two antral and one body bio psy (CLO 3), and with histological examination for H. pylori. Consecutive p atients undergoing upper gastrointestinal endoscopy (UGIE) at Stepping Hill Hospital, Stockport, UK, who had evidence of gastritis, gastric ulcer, duo denitis or duodenal ulcer were included in the study. Results Ninety-six patients were biopsied. Forty were positive on at least one of the CLOtests; of these, nine were negative on histological assessmen t. Of these nine, two were positive on all CLOtests and seven were positive only on CLO 3, One was positive on histology but negative on all CLOtests, This study showed that CLO 3 was more sensitive than CLO 1 (P = 0.004), CL O 2 (P = 0.016) and histology (P = 0.022). There was no significant differe nce between CLO 1 and CLO 2 (P = 0.500), CLO 1 and histology (P = 1.000), C LO 2 and histology (P = 1.00). Conclusion We feel that in a busy clinical setting, taking two antral and o ne body biopsy in a single CLOtest is superior to routine histological asse ssment for the detection of H. pylori, with resulting cost saving. Eur J Ga stroenterol Hepatol 13:387-390 (C) 2001 Lippincott Williams & Wilkins.