Published online Feb 16, 2024. doi: 10.4253/wjge.v16.i2.64
Peer-review started: November 14, 2023
First decision: December 5, 2023
Revised: December 24, 2024
Accepted: January 11, 2024
Article in press: January 11, 2024
Published online: February 16, 2024
A reliable test is essential for diagnosing Helicobacter pylori (H. pylori) infection, and crucial for managing H. pylori-related diseases. Serving as an excellent me
To investigate the discordance between histology and other H. pylori tests, the underlying causes, and the impact on clinical management.
Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018. Reports were included in the study only if there were other H. pylori tests within seven days of the biopsy. These additional tests include CLO test, SA, and H. pylori culture. Concordance between histopathology and other tests was determined based on the consistency of results. In instances where histology re
Of 1396 pathology reports were identified, each accompanied by one additional H. pylori test. The concordance rates in detecting H. pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments. 117 discrepant cases were identified. Only 20 cases (9 with CLO test and 11 with SA) had negative biopsy but positive results in other tests. Four cases initially stained with Warthin-Starry turned out to be positive for H. pylori with subsequent IHC staining. Among the remaining 16 true discrepant cases, 10 pa
There are rare discrepant cases with negative biopsy but positive in SA or CLO test. Various factors may contribute to this inconsistency. Most patients in such cases had undergone treatment.
Core Tip: The concordance between histopathology and rapid urease test (CLO test) or stool antigen test (SA) for detecting Helicobacter pylori (H. pylori) detection is excellent. The agreement between histology and H. pylori culture is good. Concordance between histopathology and other tests shows no significant differences based on the number of biopsy fragments. Occasionally, there are rare cases where histology is negative for H. pylori, while the CLO test or SA is positive. The causes of such discrepancies may be multifactorial, necessitating a separate analysis for each case with clinical correlation. Most of these cases were subsequently treated for H. pylori infection.