Abstract
A variety of reliable methods are available fordetecting Helicobacter pylori (Hp) during uppergastrointestinal endoscopy. We evaluated the clinicalutility and cost-effectiveness of rapid urease test (RUT), touch cytology (TC), and histology (H).Two hundred thirty-eight consecutive patients (178without previous medical treatment and 60 formerlytreated with anti-Hp therapy) were tested for Hpinfection by RUT, TC, and H (H&E stain). Theinfection status for each patient was established by aconcordance of two test results. The time to carry outthe three tests and their cost were also calculated. Sensitivity of TC (100%) was significantlyhigher than that of RUT (86.8%; P < 0.001), but notthan that of H (94.9%). RUT was significantly morespecific than H (100% vs 95.6%; P < 0.05), but not than TC (96.4%). Hp infection was more frequentin the patients with chronic active gastritis than inthose with chronic nonactive gastritis (P < 0.001).No Hp infection was detected in absence of chronic antral inflammation. RUT resulted the cheapestmethod and H the most expensive; TC is faster andcheaper than H. When additional information about theseverity of mucosal damage or the presence of cell atypias is not necessary, histologicexamination can be omitted, and a cost-effectivestrategy for assessing Hp status might consist in takingtwo antral biopsies, the former for performing RUT andthe latter for preparing a slide by TC, whichshould be stained and examined only when the RUT resultis negative.
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Trevisani, L., Sartori, S., Ruina, M. et al. Touch Cytology (A Reliable and Cost-Effective Method for Diagnosis of Helicobacter pylori Infection). Dig Dis Sci 42, 2299–2303 (1997). https://doi.org/10.1023/A:1018874919571
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DOI: https://doi.org/10.1023/A:1018874919571