Which biopsy test was more sensitive for detecting H. pylori?

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The study aimed to determine the diagnostic accuracy of biopsy-based tests for Helicobacter pylori infection, using histopathology as the gold standard.

This validation study was conducted from August 2018 to February 2019 at the pathology department of Khyber Medical College, Peshawar. It included biopsy samples from 87 patients obtained by endoscopy at the gastrointestinal endoscopy department of Hayatabad Medical Complex (HMC). Patients with a history of prior antibiotics and proton pump inhibitors (PPIs) were excluded. The rapid urease test (RUT) and culture of gastroduodenal biopsies were validated against histopathological examination of gastroduodenal mucosa.

Of the 87 patients, 57.47% (50/87) were male and 42.52% (37/87) were female. Ages ranged from 18 to 80 years, with a mean of 45 years. Endoscopic findings included gastritis in 64.36% (56/87), duodenitis in 6.89% (6/87), peptic and duodenal ulcers in 22.98% (20/87), erosion in 4.59% (4/87), and stomach adenocarcinoma in 2.29% (2/87).

Culture had a sensitivity of 45.45%, specificity of 90.7%, positive predictive value of 62.5%, and negative predictive value of 83%. RUT had a sensitivity of 81.81%, specificity of 90%, positive predictive value of 90%, and negative predictive value of 94%. In the conclusion, the authors reported rounded sensitivity and specificity values of 82% and 90% for RUT and 45% and 91% for culture.