Diagnostic Approaches for Helicobacter pylori Infection and their Comparison
Helicobacter pylori (H. pylori) can be the reason for several health problems, and there are a few diagnoses that can be done with the following two methods:
- Histopathological analysis
- Rapid Urease Test (RUT).
In this post, we will briefly compare the accuracy of these two methods.
To identify H. pylori, many medical professionals prefer the rapid urease test (RUT) method as it is fast and costs less. The pH value of urine increases because of H. pylori, which can produce certain enzymes. Test results can be obtained within an hour.
RUT has drawbacks, such as decreased accuracy brought on by recent use of antibiotics, proton pump inhibitors, or biopsy sample placement. Patients receiving therapies that inhibit bacterial activity or those with low bacterial loads may experience false negative results. Also, with the RUT method, one can only detect urease and not know how much a person is infected.
On the other hand, medical professionals rely more on the results of histopathology analysis to detect H. pylori infection.
There are a few tissue staining methods available such as:
- Hematoxylin and Eosin (H&E)
- Modified Giemsa (MG)
By using these methods, one can see the presence of H. pylori through a microscope.
With the help of histopathological analysis, a doctor can perform the following:
- How much of the patient’s stomach is infected
- Degree of inflammation
- Epithelial damage
- MALT lymphoma
- Gastric cancer.
Compared to RUT, histopathological analysis has a greater specificity and can detect additional causes of gastritis or alterations in the stomach mucosa. H. pylori can be seen and its density and location inside the stomach lining evaluated with the use of H&E and MG staining procedures, which provide important information that the RUT cannot provide.
However, histopathology requires expertise, is more time-consuming, and involves additional costs and resources.
Additionally, histological interpretation can be subjective, depending on the pathologist’s experience.
Recent studies comparing RUT with histopathological examination have shown promising results. RUT’s sensitivity, specificity, and accuracy were 95.24%, 89.19%, and 93%, respectively, in a trial including 100 patients. In another study with 105 patients, the percentage of patients with RUT who tested positive for H. pylori was 59.05%, whereas the percentage with histology was 60%.
Histopathology, particularly with H&E and MG stains, showed 100% specificity but somewhat lower sensitivity, whereas RUT had 82.54% sensitivity and 76.19% specificity.
These results imply that although both approaches are quite dependable, RUT can be a trustworthy first test for identifying H. pylori infection, particularly in environments with limited resources. RUT is a quick, less intrusive option that yields results quickly enough to inform clinical judgment.
To confirm the diagnosis, gauge the extent of the infection, and rule out other illnesses, histological investigation is still crucial. Histological assessment should be taken into consideration to guarantee an accurate diagnosis in situations where RUT results are negative but clinical suspicion is still high.
Conclusion
For H. pylori, the Rapid Urease Test (RUT) is a rapid and affordable diagnostic method, however histopathology analysis is still the gold standard and offers comprehensive information. RUT for screening and histopathology for confirmation are complementary assays.
