Comparison of Four Invasive Methods for Diagnosis of Helicobacter pylori Infection: Fluorescence in situ Hybridization,
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ETHODS OF RESEARCH
Comparison of Four Invasive Methods for Diagnosis of Helicobacter pylori Infection: Fluorescence in situ Hybridization, Histology, Culture, Rapid Urease Test Jina Vazirzadeha, Sharareh Moghima, Jamal Falahib, Tahmine Narimania, Rahmatollah Rafieic, and Vajihe Karbasizadeha, * a
Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran b Department of Medicine, Zahedan Medical Branch, Islamic Azad University, Zahedan, Iran c Najafabad Branch, Islamic Azad University, Najafabad, Iran *e-mail: [email protected] Received September 16, 2019; revised September 24, 2019; accepted September 26, 2019
Abstract—Background: Helicobacter pylori (H. pylori) is one of the most prevalent pathogenic bacteria globally. Choosing reliable methods will lead to a correct diagnosis of infection. The aim of this study was to evaluate four H. pylori infection diagnostic methods from dispeptic patients. Methods: In this descriptive crosssectional study, 165 antrum biopsy specimens were obtained from dyspeptic patients referred to the endoscopy unit of Shariati Hospital, Isfahan, Iran, and collected in 2018. Four diagnostic methods of H. pylori, namely histology, culture, rapid urease test (RUT) and fluorescence in situ hybridisation (FISH) were tested for each patient. The gold standard of the study was for positive confirming one of the two tests, RUT or histology. Results: According to the predefined criteria, the prevalence of H. pylori infection was 55.2%. Among the four diagnostic methods, the most sensitive ones were FISH and RUT, respectively (95.7 and 92.3%). Despite the high specificity of the histological examination (100%), its NPV was lower than the other methods (88%). The kappa coefficient of agreement between the gold standard and the tested techniques was perfect (P < 0.001). Conclusion: FISH and histology are recommended in combination with diagnosis of H. pylori infection, which can manage its complications in the most optimal manner. Keywords: Helicobacter pylori, fluorescence in situ hybridization, histology, culture, rapid urease test DOI: 10.3103/S0891416820020111
INTRODUCTION Helicobacter pylori (H. pylori) is a Gram-negative and microaerophilic spiral shaped bacterium [1]. H. pylori infection is recognized as the major cause of chronic gastritis in the human stomach of more than half of the world population [2]. This microorganism is associated with the development of gastric cancer, peptic ulcer and gastric mucosa-associated lymphoid tissue (MALT) lymphoma, which is reported worldwide [3]. Gastric adenocarcinoma is the second resulting cause of cancer death worldwide [4]. The prevalence of acute infection rate varies among regions, seeming to be highly prevalent in developing (70–90%) rather than developed countries (25–50%) [5]. In Iran, the prevalence of gastric infection with H. pylori is known to be high, with the reported prevalence ranging from 36 to 90% over different geographic areas [6]. H. pylori infection can be diagnosed by invasive a
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