[Investigation of the presence of Helicobacter pylori by different methods in patients with dyspeptic complaints].

Helicobacter pylori infections which are common worldwide may be a risk factor for gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphomas. For the detection of H. pylori, invasive methods such as culture, histopathology and rapid urease tests which require endoscopy and gastric biopsy specimen and non-invasive methods (not requiring endoscopy) such as urea breath test, stool antigen test (H. pylori stool antigen; HpSA) and serology are used. The aim of this study was to investigate the presence of H. pylori in patients with dyspeptic complaints, by rapid urease test, HpSA test, culture and histopathology and to evaluate the diagnostic performance of HpSA test. A total of 103 dyspeptic patients who were admitted to Selcuk University Meram Medical Faculty Gastroenterology Clinic and undergone gastroduodenal endoscopy between January 2005 and December 2006, were included to the study. All the specimens were cultivated, however, urease activity was tested in 98 of the patients, histopathological examination in 76 and HpSA test in 86 of the patients. H. pylori was isolated in 38.8% (40/103) of the specimens by culture. H. pylori was positive in 38.2% (29/76) of the specimens by histopathology, in 86.7% (85/98) by urease test, and in 44.2% (38/86) by HpSA test. The sensitivity and specificity values of the tests when culture was taken as the gold standard, were; 97.5% and 20.7% for urease test, 75% and 82.6% for HpSA test and 72.5% and 100% for histopathology, respectively. In conclusion, HpSA method could be applied as a screening test for H. pylori diagnosis in case endoscopy could not be performed. However, if invasive methods were to be performed, the diagnosis should be confirmed by a more sensitive and specific test such as culture and histopathology.