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Helicobacter pylori detection: a quality and cost analysis
B E Kolts1, B Joseph, S R Achem
1Department of Medicine, University of Florida Health Science Center, Jacksonville.
The American Journal of Gastroenterology
|May 1, 1993
Summary
Histopathologic interpretation of hematoxylin and eosin (H&E) stains is a common method for identifying Helicobacter pylori. The CLOtest offers a rapid, cost-effective alternative with comparable accuracy to experienced pathologists.
Area of Science:
- Medical Diagnostics
- Gastroenterology
- Pathology
Background:
- Histopathologic interpretation of hematoxylin and eosin (H&E) stained endoscopic biopsies is a standard method for detecting Helicobacter pylori.
- Limited data exists on the accuracy of H&E staining and cost-effectiveness of alternative diagnostic methods.
Purpose of the Study:
- Compare sensitivities and specificities of H&E, Warthin-Starry silver, Giemsa stains, and CLOtest for H. pylori identification.
- Evaluate the impact of pathologist experience on H&E stain accuracy.
- Assess diagnostic turnaround time and patient charges for each method.
Main Methods:
- Evaluated 94 consecutive cases using H&E, Warthin-Starry silver, Giemsa stains, and CLOtest.
- Utilized silver stain or a combination of tests as the diagnostic standard.
- Compared H&E interpretation by rotating pathology faculty versus an experienced pathologist.
Main Results:
- Rotating pathologists' H&E interpretation showed low sensitivity and specificity.
- Silver and Giemsa stains demonstrated equal sensitivity, with silver stain being more specific.
- CLOtest was less sensitive but equally specific compared to silver and Giemsa stains.
- An experienced pathologist significantly improved H&E sensitivity.
Conclusions:
- H&E stain accuracy for H. pylori detection is influenced by pathologist experience.
- The CLOtest is a viable, rapid, and cost-effective alternative to H&E staining.
- Experienced pathologists enhance H&E stain utility in H. pylori diagnosis.