Diagnostic value of culture, histology and PCR for Helicobacter pylori in the remnant stomach after surgery.
BACKGROUND
Diagnosis of Helicobacter pylori infection in the remnant stomach has not been established.


OBJECTIVE
To investigate the diagnostic value of culture, histology, PCR and serum IgG against H. pylori (ELISA) with and without eradication therapy in the remnant stomach, compared with the unoperated stomach.


METHODS
Biopsy samples for bacterial culture and histological diagnosis of H. pylori were taken from the stoma and upper corpus of the remnant stomach and gastric juice was used for PCR assay.


RESULTS
Bacterial culture-based diagnosis in the remnant stomach, sensitivity and specificity of culture were 95.1%, 100%; histology 89%, 92.3%; PCR 66%, 89.7%; and ELISA 100%, 50%, respectively, in cases without H. pylori eradication therapy. In assessment of the results of therapy for the remnant stomach, sensitivity and specificity of culture were 100%, 100%; histology 80%, 96.8%; PCR 80%, 91.7%; and ELISA 100%, 0%, respectively.


CONCLUSIONS
Bacterial culture had the highest diagnostic value in the remnant stomach as well as unoperated stomach. Sensitivity by histology and PCR was lower in the remnant stomach than the unoperated stomach, but specificity values were equal. Serum ELISA assay was not suitable for the remnant stomach.
Matsukura
N
N
Surgery for Organ Function and Biological Regulation (First Department of Surgery) and Second Department of Pathology, Nippon Medical School, Tokyo, Japan. matsun@nms.ac.jp
Tajiri
T
T
Kato
S
S
Togashi
A
A
Masuda
G
G
Tokunaga
A
A
Yamada
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques / Q000592:standards; D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards; D005260:Female; D005750:Gastric Juice / Q000382:microbiology; D016481:Helicobacter Infections / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000592:standards; D011183:Postoperative Complications / Q000382:microbiology / Q000473:pathology*; D012680:Sensitivity and Specificity; D013270:Stomach / Q000473:pathology; D013274:Stomach Neoplasms / Q000382:microbiology / Q000473:pathology / Q000601:surgery*