Comparison of polymerase chain reaction and histopathology for the detection of Helicobacter pylori in gastric biopsies.
Using data from a Venezuelan cohort of 1,948 adults, the gastric detection of Helicobacter pylori (H. pylori) by polymerase chain reaction (PCR) of the vacA gene in 1 antral biopsy was compared to the detection of H. pylori by histopathology (hematoxylin-eosin and Giemsa staining) in 5 biopsies (antrum and corpus). Overall, H. pylori was detected in 85% and 95% of the subjects by PCR and histopathology, respectively. When results were analyzed by severity of precancerous lesions, PCR on 1 biopsy detected the bacteria less often than histopathology on 5 biopsies in subjects with normal gastric mucosa and non-atrophic gastritis. However, in subjects with the most severe lesions (intestinal metaplasia type III and dysplasia), PCR on 1 biopsy detected H. pylori as often as histopathology on 5 biopsies, and significantly more often than histopathology on a single biopsy. In conclusion, these findings confirm that histopathology on 5 biopsies is an accurate tool for H. pylori detection in most subjects, compared to the PCR method on 1 biopsy. Nevertheless, the elevated sensitivity of PCR for detecting the bacteria in advanced precancerous lesions, and the possibility to use PCR to distinguish between cagA-positive and cagA-negative strains, makes the PCR technique especially useful in studies of stomach cancer.
de Martel
Catherine
C
International Agency for Research on Cancer, Lyon, France.
Plummer
Martyn
M
International Agency for Research on Cancer, Lyon, France.
van Doorn
Leen-Jan
LJ
DDL Diagnostic Laboratory, Voorburg, The Netherlands.
Vivas
Jorge
J
Cancer Control Center of Tachira State, San Cristobal, Venezuela.
Lopez
Gladys
G
Cancer Control Center of Tachira State, San Cristobal, Venezuela.
Carillo
Elsa
E
Cancer Control Center of Tachira State, San Cristobal, Venezuela.
Peraza
Simon
S
Cancer Control Center of Tachira State, San Cristobal, Venezuela.
Muñoz
Nubia
N
Insituto Nacional de Cancerología, Bogota, Colombia.
Franceschi
Silvia
S
International Agency for Research on Cancer, Lyon, France.
D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000235:genetics / Q000302:isolation & purification; D006651:Histocytochemistry / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D011230:Precancerous Conditions / Q000382:microbiology* / Q000601:surgery; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000382:microbiology* / Q000601:surgery