ABSTRACT
Helicobacter pylori has been associated with a variety of upper gastrointestinal diseases. Histopathological examination and culture are considered to be the more specific tests in the diagnosis of H. pylori infection. In the present study, we evaluated the efficiency of a polymerase chain reaction (PCR) assay of the H. pylori urease A gene as a procedure in the diagnosis of gastric H. pylori infection in various gastroduodenal diseases. Biopsy specimens were obtained from the antral mucosa of 83 patients during endoscopic examination and were submitted to three tests for the detection of H. pylori infection. The detection rates of H. pylori using PCR, histopathological examination and culture were 84, 77 and 63%, respectively. When the infection was defined, by the agreement of culture and histopathological examination or by positive culture, the PCR assay had a sensitivity of 98.1% and a specificity of 84.6%. When the infection was defined by a positive result of either two of the three tests or by positive culture, the PCR assay had a sensitivity of 98.6% and a specificity of 85.7%. We conclude that the PCR assay is a valuable test for the diagnosis of H. pylori infection in gastroduodenal diseases.
Subject(s)
Duodenal Diseases/diagnosis , Helicobacter Infections/diagnosis , Helicobacter pylori , Stomach Diseases/diagnosis , Adult , Aged , Aged, 80 and over , Base Sequence , DNA, Bacterial/analysis , Duodenal Diseases/microbiology , Duodenal Diseases/pathology , Female , Gastric Mucosa/microbiology , Gastric Mucosa/pathology , Genes, Bacterial , Helicobacter Infections/microbiology , Helicobacter Infections/pathology , Helicobacter pylori/enzymology , Helicobacter pylori/genetics , Helicobacter pylori/isolation & purification , Humans , Male , Middle Aged , Molecular Sequence Data , Polymerase Chain Reaction , Predictive Value of Tests , Sensitivity and Specificity , Stomach Diseases/microbiology , Stomach Diseases/pathology , Urease/geneticsABSTRACT
Congestive gastropathy is a common cause of gastrointestinal bleeding in cirrhotic patients. Forty-six patients with cirrhosis of the liver and 225 control subjects matched in age and sex without cirrhosis of the liver entered the study. We studied the prevalence of congestive gastropathy in cirrhotic patients, and the relationship between endoscopic and histological findings. Congestive gastropathy seen endoscopically was found to be more common in the cirrhotic group than in the control (85% vs. 5%, P < 0.05). The sensitivity, specificity and positive predictive value were 85%, 95% and 76%, respectively. The presence of endoscopic congestive gastropathy was correlated with the severity of liver disease (P < 0.05), but not to the etiology of cirrhosis and the size of esophageal varices with or without red color sign. Endoscopic congestive gastropathy showed no correlation with the histological features including gastritis, interstitial edema, vessel ectasia/congestion and hemosiderin in endoscopic biopsy specimens. In conclusion, congestive gastropathy is a common finding in cirrhotic patients. Its appearance is closely correlated with the severity of liver disease. There is no good correlation between endoscopic congestive gastropathy and mucosal histology.
