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Helicobacter‐ negative gastritis: polymerase chain reaction for Helicobacter DNA is a valuable tool to elucidate the diagnosis
Author(s) -
Kiss S.,
Zsikla V.,
Frank A.,
Willi N.,
Cathomas G.
Publication year - 2016
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13564
Subject(s) - helicobacter pylori , gastritis , polymerase chain reaction , helicobacter , primer (cosmetics) , gastroenterology , pathology , histology , medicine , chronic gastritis , biopsy , biology , gene , chemistry , genetics , organic chemistry
Summary Background Helicobacter ‐negative gastritis has been increasingly reported. Molecular techniques as the polymerase chain reaction ( PCR ) may detect bacterial DNA in histologically negative gastritis. Aim To evaluate of Helicobacter PCR in gastric biopsies for the daily diagnostics of Helicobacter ‐negative gastritis. Methods Over a 5‐year period, routine biopsies with chronic gastritis reminiscent of Helicobacter infection, but negative by histology, were tested by using a H. pylori specific PCR . Subsequently, PCR ‐negative samples were re‐evaluated using PCR for other Helicobacter species. Results Of the 9184 gastric biopsies, 339 (3.7%) with histological‐negative gastritis and adequate material were forwarded to PCR analysis for H. pylori and 146 (43.1%) revealed a positive result. In 193 H. pylori DNA ‐negative biopsies, re‐analysis using PCR primers for other Helicobacter species, revealed further 23 (11.9%) positive biopsies, including 4 (2.1%) biopsies with H. heilmannii sensu lato . PCR ‐positive biopsies showed a higher overall inflammatory score, more lymphoid follicles/aggregates and neutrophils ( P < 0.05). No Helicobacter DNA was found in control biopsies of 48 patients with neither primer set ( P < 0.0001). In 274 patients with an endoscopic description, detection of H. pylori DNA was associated with ulcers and erosions ( P < 0.01). Over all, in 339 histologically‐negative gastric biopsies, Helicobacter DNA was detected in 169 (49.9%) samples with at least one primer set. Conclusion Molecular testing offers a sensitive and specific diagnosis to a selected group of patients, in whom adequate searches for bacteria by conventional histology have resulted in the unsatisfactory diagnosis of H. pylori ‐negative gastritis.