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Updated: Aug 23, 2025
Author Spotlight: Detection and Treatment of Helicobacter pylori Infection
Published on: July 28, 2023
Diagnosis and Comparison of Three Invasive Detection Methods for Helicobacter pylori Infection
Saifa Kismat1, Nusrat Nur Tanni1, Rokshana Akhtar1
1Department of Microbiology and Immunology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Background:
The purpose of this study was to compare different invasive methods for Helicobacter pylori (H. pylori) detection, namely PCR for H. pylori specific ureC gene, Rapid urease test (RUT), and histopathological examination by modified Giemsa staining.
Methodology:
Endoscopic gastroduodenal biopsy materials were collected from dyspeptic patients who underwent endoscopic examination upon fulfilling the inclusion criteria. Three to four samples were collected from each patient after taking informed consent and proper clinical history. A rapid urease test (RUT) was done on spot with in-house RUT media from 1 specimen. One to two specimens were preserved in 10% formaldehyde for histopathology and PCR for ureC gene was done from 1 specimen. Collected biopsy specimens from gastric and duodenal mucosa of 142 patients were categorized as H. pylori-positive cases and H. pylori-negative cases based on the case definition used in the study upon positivity of 3 diagnostic tests.
Results:
Among 142 biopsy specimens, 34.5% were categorized as H. pylori-positive cases, 35.2% as H. pylori-negative cases, and finally 30.2% as doubtful or indeterminate cases. Rapid urease test was the most sensitive method, closely followed by ureC gene PCR and histopathology, with a sensitivity of 94.2%, 83.0%, and 76.5%, respectively. Whereas histology was the most specific, having 98.0% specificity followed by 83.0% in PCR. RUT was the least specific, with 55.5% specificity.
Conclusion:
While histopathology could detect H. pylori infection with the highest specificity, for definitive diagnosis combination of any 2 methods should be used, if available.
Insights
The Rapid Urease Test (RUT) showed the highest sensitivity for detecting Helicobacter pylori infection, while histopathology offered the greatest specificity. Combining diagnostic methods is recommended for definitive H. pylori diagnosis.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Diagnostic Microbiology
Background:
- Helicobacter pylori (H. pylori) infection is a significant cause of gastroduodenal diseases.
- Accurate and reliable detection methods are crucial for effective H. pylori diagnosis and treatment.
- Invasive biopsy-based methods are commonly employed for H. pylori detection.
Purpose of the Study:
- To compare the diagnostic performance of three invasive H. pylori detection methods.
- To evaluate the sensitivity and specificity of PCR for the ureC gene, Rapid Urease Test (RUT), and histopathology.
Main Methods:
- Gastroduodenal biopsy specimens were collected from 142 dyspeptic patients.
- H. pylori detection was performed using Rapid Urease Test (RUT), PCR for the ureC gene, and modified Giemsa staining for histopathology.
- Specimens were analyzed for H. pylori positivity based on predefined criteria.
Main Results:
- The Rapid Urease Test (RUT) demonstrated the highest sensitivity (94.2%), followed by ureC gene PCR (83.0%) and histopathology (76.5%).
- Histopathology exhibited the highest specificity (98.0%), with ureC gene PCR at 83.0% and RUT at 55.5%.
- A significant proportion of cases (30.2%) were indeterminate or doubtful.
Conclusions:
- While histopathology provides the highest specificity for H. pylori detection, it has lower sensitivity compared to RUT and PCR.
- The Rapid Urease Test (RUT) is the most sensitive invasive method for H. pylori diagnosis.
- A combination of any two diagnostic methods is recommended for definitive H. pylori diagnosis, balancing sensitivity and specificity.
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