Przeglad gastroenterologiczny · 2025
Concordance of the rapid urease test and the histopathology report in detecting Helicobacter pylori infection in a bariatric population. A retrospective cohort study.
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Panek Piotr, Rymarowicz Justyna, Czeliński Miłosz, Pośpiech Jakub, Dembiński Marcin, Winiarski Marek, Major Piotr, Kukla Michał
Аннотация
INTRODUCTION: Bariatric surgery has become one of the most prominent treatment modalities for obesity. Esophagogastroscopy (EGD) with Helicobacter pylori testing is a part of the preoperative work-up. There are no guidelines defining the preferred method of detecting H. pylori.
AIM: The study aimed to establish the prevalence of H. pylori infection among bariatric patients and compare the two commonly used invasive diagnostic tests: the rapid urease test (RUT) and histopathology. The secondary aim was to evaluate the usefulness of EGD and histology in diagnosing gastritis.
MATERIAL AND METHODS: A retrospective analysis was performed among patients with obesity undergoing bariatric surgery. As part of the preoperative work-up, EGD was performed with RUT using the Lencomm GOLD Hp dry CLO test and a histopathology sample taken from the gastric antrum and body. The Cohen's kappa inter-rated reliability test was used for concordance calculation.
RESULTS: 280 patients were analyzed, of whom 98 (35.00%) were diagnosed with H. pylori infection with at least one method. The Cohen's kappa inter-rated agreement between the RUT and histology sampling was 0.80. Macroscopic gastritis was present in 76 (77.56%) of infected patients. Histology showed microscopic gastritis in 99 (99%) of those patients. 161 (57.50%) of the study group were diagnosed with macroscopic gastritis; among these, histology confirmed inflammation in 119 (73.91%).
CONCLUSIONS: There is a good concordance between RUT and histopathology diagnosis of H. pylori among the bariatric population. Additionally, there is a low accuracy rate in EGD assessments of gastric mucosa changes.
AIM: The study aimed to establish the prevalence of H. pylori infection among bariatric patients and compare the two commonly used invasive diagnostic tests: the rapid urease test (RUT) and histopathology. The secondary aim was to evaluate the usefulness of EGD and histology in diagnosing gastritis.
MATERIAL AND METHODS: A retrospective analysis was performed among patients with obesity undergoing bariatric surgery. As part of the preoperative work-up, EGD was performed with RUT using the Lencomm GOLD Hp dry CLO test and a histopathology sample taken from the gastric antrum and body. The Cohen's kappa inter-rated reliability test was used for concordance calculation.
RESULTS: 280 patients were analyzed, of whom 98 (35.00%) were diagnosed with H. pylori infection with at least one method. The Cohen's kappa inter-rated agreement between the RUT and histology sampling was 0.80. Macroscopic gastritis was present in 76 (77.56%) of infected patients. Histology showed microscopic gastritis in 99 (99%) of those patients. 161 (57.50%) of the study group were diagnosed with macroscopic gastritis; among these, histology confirmed inflammation in 119 (73.91%).
CONCLUSIONS: There is a good concordance between RUT and histopathology diagnosis of H. pylori among the bariatric population. Additionally, there is a low accuracy rate in EGD assessments of gastric mucosa changes.