Detection of H. pylori in gastric biopsies: A cost effective method for developing countries.

Abstract

H. pylori is the most common organism implicated in the pathogenesis of chronic gastritis. The aim of this study is to assess the reliability and cost effectiveness of hematoxylin and eosin (H&E) stain for the detection of H. pylori in gastric biopsies for developing countries with immunohistochemical markers (IHC) as gold standard. Study Design: Descriptive cross-sectional study. Setting: OPD of Kuwait teaching hospital and Mercy teaching hospital. Period: April 2017 to December 2017. Materials and Methods: 50 consecutive endoscopic gastric biopsies collected according to the Updated Sydney Protocol from patients with dyspeptic symptoms. The data was entered and analyzed in SPSS version 19. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each staining technique. Chi square test was used for calculating p value. A value less than or equal to 0.05 was considered statistically significant. Results: The most common presenting symptom was epigastric pain, nausea/vomiting and bloating/burping. According to Updated Sydney Protocol, the most common diagnosis was mild chronic inflammation. Sensitivity, specificity, p ositive predictive and negative predictive value of H&E was 46.8 %, 88.8%, 88.2% and 48.5% respectively. Conclusion: Our study concludes that used alone H&E can easily detect H. pylori in gastric biopsies in most of the cases. However, IHC may be used in selected patients with negative H&E results and strong clinical suspicion of H. pylori infection.