Frozen-section biopsy in perendoscopic diagnosis of Helicobacter pylori

Our goal was to investigate how reliably Helicobacter pylori infection can be diagnosed from gastric biopsy specimens by frozen-section technique.

The series consisted of 105 consecutive outpatients who underwent diagnostic upper gastrointestinal endoscopy for abdominal complaints at Jorvi Hospital (Espoo, Finland) during the beginning of 1996. Endoscopic biopsies from antrum and corpus were taken for both frozen-section and traditional histology, the latter serving as reference (control) material. In the frozen-section technique, the biopsy specimens were transferred immediately to the pathology laboratory, were prefixed for 30 sec in 10% neutral formalin, were frozen in liquid nitrogen, and were cut into sections with a cryostat. The sections were stained for 10 minutes with 1% toluidine blue. The control biopsy specimens were fixed overnight in 10% neutral formalin and embedded in paraffin, and the sections were stained with the modified Giemsa method.

In the diagnosis of H. pylori infection, both the sensitivity and the specificity of the frozen-section technique were 98% compared to the findings in the reference series. One false-negative result occurred among 41 positive cases, and one case erroneously was classified positive among 64 cases that were negative for H. pylori in the ordinary histology. The frozen-section technique slightly underestimated the degree of colonization of the gastric mucosa by H. pylori, compared to the findings in the reference material. In the diagnosis of gastritis (chronic inflammation of any degree), the sensitivity and specificity of frozen sections were 92% and 95%, respectively. In the frozen-section technique, the report of the pathologist of the presence or absence of H. pylori gastritis in biopsy specimens could be given to the gastroenterologist by telephone in approximately 20 minutes.

The frozen-section technique is a reliable and rapid method for the diagnosis of H. pylori and provides possibilities for perendoscopic diagnosis of the infection in the hospitals where the frozen-section service is available.