Evaluation of optimal gastric mucosal biopsy site and number for identification of Helicobacter pylori, gastric atrophy and intestinal metaplasia.
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.
Dursun
Mehmet
M
Department of Gastroenterology, Faculty of Medicine, Dicle University, Diyarbakir, Turkey. dursunm@dicle.edu.tr
Yilmaz
Serif
S
Yükselen
Vahit
V
Kilinç
Nihal
N
Canoruç
Fikri
F
Tuzcu
Alpaslan
A
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