title: Evaluation of optimal gastric mucosal biopsy site and number for identification of Helicobacter pylori, gastric atrophy and intestinal metaplasia.
abstract: OBJECTIVE
  The study is designed to identify the optimal gastric mucosal biopsy site and number for identification of Helicobacter pylori, gastric atrophy and intestinal metaplasia.
  
  
  METHODS
  Ninety-two patients were included in the study, gastric biopsies were obtained from 5 different sites: lesser curvature of the mid-antrum (A1), greater curvature of the mid-antrum (A2), incisura angularis (IA), lesser curvature of the mid-corpus (B1), greater curvature of the mid-corpus (B2). Helicobacter pylori was evaluated in sections stained with toluidine blue, and histopathological examination was performed in sections stained with hematoxylin-eosin.
  
  
  RESULTS
  Seventy-three patients were positive for Helicobacter pylori at least in one biopsy site. Helicobacter pylori was positive in 47 patients (64.3%) in A1, in 54 patients (73.9%) in A2, in 60 patients (82.1%) in IA, 44 patients (60.2%) in B1, and in 42 patients (57.5%) in B2. The highest positivity determined was in the combination of A2 and IA sites (95.8%). Gastric atrophy was determined in 35 of 73 patients (27.1% in A1, 20% in A2, 25.7% in IA, 20% in B1, and 7% in B2). Intestinal metaplasia was determined in 31 of the Helicobacter pylori-positive patients (18% in A1, 16% in A2, 30.9% in IA, 21.8% in B1, 12.7% in B2).
  
  
  CONCLUSIONS
  It is considered that taking biopsies from both A1 and IA sites has the highest sensitivity in detecting Helicobacter pylori. However, it is difficult to define a specific site for detecting gastric atrophy and intestinal metaplasia.
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. dursunm@dicle.edu.tr
authors.forename: Mehmet
authors.initials: M
authors.lastname: Dursun
authors.forename: Serif
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Vahit
authors.initials: V
authors.lastname: Yükselen
authors.forename: Nihal
authors.initials: N
authors.lastname: Kilinç
authors.forename: Fikri
authors.initials: F
authors.lastname: Canoruç
authors.forename: Alpaslan
authors.initials: A
authors.lastname: Tuzcu
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005757:Gastritis, Atrophic / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007150:Immunohistochemistry; D007422:Intestines / Q000473:pathology*; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D018570:Risk Assessment; D012680:Sensitivity and Specificity