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Detection of Helicobacter pylori Gastritis by PCR
Correlation With Inflammation Scores and Immunohistochemical and CLOtest Findings

Jason Weiss DO, Tat-Kin Tsang MD, Xiangwen Meng MD, PhD, H. Zhang MD, PhD, Elizabeth Kilner, Edward Wang PhD, William Watkin MD
DOI: http://dx.doi.org/10.1309/APMPEP54G7PN958G 89-96 First published online: 1 January 2008

Abstract

We developed a polymerase chain reaction (PCR) assay to detect Helicobacter pylori in gastric and/or gastroesophageal biopsy specimens of adults with dyspepsia, compared the method with immunohistochemical analysis and CLOtest (Ballard Medical Products, Draper, UT), and correlated the results of each test with the histologic features of infection. H pylori was identified in 36 (60%) of 60 patients irrespective of biopsy site and testing method. In the gastric biopsy specimens, PCR detected H pylori in 29 (52%) of 56 cases, including 11 (100%) of 11 immunohistochemically and/or CLOtest-positive cases. PCR-positive gastric biopsy specimens correlated with a higher average cumulative inflammatory score compared with PCR-negative specimens (P = .001). In gastroesophageal biopsy specimens, PCR detected H pylori in 15 (34%) of 44 cases, including 1 (20%) of 5 immunohistochemically positive specimens. PCR-positive gastroesophageal junction biopsy specimens did not correlate with a higher average cumulative inflammatory score. Overall, PCR detected an additional 23 cases negative by immunohistochemical analysis and/or CLOtest. This PCR assay identified a significant number of H pylori infections that would not be detected by immunohistochemical analysis and/or CLOtest.

Key Words:
  • Helicobacter pylori
  • Polymerase chain reaction
  • Gastritis
  • Histology
  • Sydney system
  • Endoscopic biopsies
  • Immunohistochemistry