SENSITIVITY AND SPECIFICITY OF MICROSCOPIC HELICOBACTER-PYLORI EVALUATION IN COMPARISON TO THE UREASE TESTING

A consecutive endoscopic-biopsy observational study was performed in 816 patients with dyspepsia to evaluate whether a pathologist or a medical student (because of his small experience) are able to identify Helicobacter pylori (H. p.) as reliably as the Urease-Test (UT). Whether one or two biopsies are neccessary for the identification and the degree of H. p.-colonisation and the degree and activity of gastritis. Compared with the UT the pathologist had a sensitivity of 94% and a specificity of 84% for H. p. identification (medical student: 99% and 69%) indicating that both were as reliable as the UT in identifying H. p. The evaluation of two instead of only one biopsy resulted in only 1% better diagnoses concerning H. p., 3% for chronic gastritis and 8% for activity of chronic gastritis. Therefore gastroenterologists should use one biopsy for microscopic investigation instead of the UT for screening-biopsy in patients with no pathological findings during endoscopy. It provides informations not only about the degree of H. p.-colonisation but also about the degree and activity of gastritis.