Who Could Be Blamed in the Case of Discrepant Histology and Serology Results for Helicobacter pylori Detection?
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2022-01
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Abstract
Background. Discrepancies between histology and serology results for Helicobacter pylori detection could be caused by a variety of factors, including a biopsy sampling error, expertise of the pathologist, natural loss of infection due to advanced atrophy, or a false-positive serology in the case of a previous infection, since antibodies may be present in blood following recovery from the infection. Aims. To identify true H. pylori-positive individuals in discrepant cases by serology and histology using real time polymerase chain reaction (RT-PCR) as a gold standard. Methods. Study subjects with discrepant histology and serology results were selected from the GISTAR pilot study data base in Latvia. Subjects having received previous H. pylori eradication therapy or reporting use of proton pump inhibitors, antibacterial medications, or bismuth containing drugs one month prior to upper endoscopy were excluded. We compared the discrepant cases to the corresponding results of RT-PCR performed on gastric biopsies. Results. In total, 97 individuals with discrepant results were identified: 81 subjects were serology-positive/histology-negative, while 16 were serologynegative/histology-positive. Among the serology-positive/histology-negative cases, 64/81 (79.0%) were false-positives by serology and, for the majority, inflammation was absent in all biopsies, while, in the serology-negative/histology-positive group, only 6.2% were proven false-positives by histology. Conclusions. Among this high H. pylori prevalent, middle-aged population, the majority of discrepant cases between serology and histology were due to false positive-serology, rather than false-negative histology. This confirms the available evidence that the choice of treatment should not be based solely on the serological results, but also after excluding previous, self-reported eradication therapy.
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Funding Information: Acknowledgments: The study was funded in part by the Fundamental and Applied Research Project Program in Latvia, project No. lzp-2018/1-0135 āResearch on implementation of a set of measures for prevention of gastric cancer mortality by eradication H. pylori and timely recognition of precancerous lesionsā. We acknowledge the entire GISTAR study team as well as the infrastructure provided by the Digestive Diseases Centre GASTRO for endoscopy and the Academic Histology Laboratory for pathology infrastructures. Our acknowledgements also to Biohit Oyj, Finland, for their support with laboratory reagents. Funding Information: Funding: The work is funded by ERDF (European Regional Development Fund) within the frame-work of 2nd part of measure 1.1.1.1. āPractical Studiesā, project ID Nr. 1.1.1.1/18/A/184. Funding Information: The work is funded by ERDF (European Regional Development Fund) within the framework of 2nd part of measure 1.1.1.1. ?Practical Studies?, project ID Nr. 1.1.1.1/18/A/184. Publisher Copyright: Ā© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Keywords
Discrepant cases, H. pylori, Histology, Polymerase chain reaction, Serology, 3.1 Basic medicine, 3.2 Clinical medicine, 1.1. Scientific article indexed in Web of Science and/or Scopus database, Clinical Biochemistry
Citation
Skrebinska, S, Megraud, F, Daugule, I, Santare, D, Isajevs, S, Liepniece-Karele, I, Bogdanova, I, Rudzite, D, Vangravs, R, Kikuste, I, Vanags, A, Tolmanis, I, Savcenko, S, Alix, C, Herrero, R, Park, J Y & Leja, M 2022, 'Who Could Be Blamed in the Case of Discrepant Histology and Serology Results for Helicobacter pylori Detection?', Diagnostics, vol. 12, no. 1, 133. https://doi.org/10.3390/diagnostics12010133