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Canadian Journal of Gastroenterology
Volume 24, Issue 10, Pages 603-606
http://dx.doi.org/10.1155/2010/156310
Original Article

Diagnostic Performance of Gastric Imprint Smear for Determination of Helicobacter pylori Infection

J Al-Ali,1 F Al-Asfar,2 R Dhar,3 PM Dhar,4 and K Kapila5

1Department of Medicine, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
2Department of Surgery, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
3Department of Laboratories (Microbiology Unit), Al-Adan Hospital, Hadiya, Kuwait
4Department of Surgery, Al-Adan Hospital, Hadiya, Kuwait
5Department of Pathology, Kuwait University, Jabriya, Kuwait

Received 8 February 2010; Accepted 12 April 2010

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Despite the availability of several methods (invasive and noninvasive) for the diagnosis of Helicobacter pylori infection, no test is considered to be the ‘gold standard’. Endoscopy-based tests are regarded as the reference method in most studies.

OBJECTIVE: To evaluate the diagnostic performance of imprint cytology smears of antral biopsies compared with Gram-stained smears, the rapid urease test and culture methods, separately and in combination.

METHODS: Antral biopsies were obtained from consecutive patients undergoing upper gastrointestinal endoscopy at a single centre. The biopsies were examined for the presence of H pylori by Gram-stained smear, the rapid urease test, culture methods and imprint cytology smear.

RESULTS: A total of 273 biopsies were studied. All tests were positive in 36% of the patients. Of 252 biopsies tested, 73% were positive using the imprint cytology technique. Using Gram-stained smear, the rapid urease test and culture methods individually, the sensitivity and specificity of imprint cytology smears for the detection of H pylori were found to be 92.7% and 50%; 92.7% and 49%; and 92.4% and 38.5%, respectively. Combining the three microbiological methods resulted in a sensitivity of 92.1%, a specificity of 51.0% and an efficiency of 71.7% for imprint cytology smears.

CONCLUSIONS: Endoscopic examination provides useful clinical information. Imprint gastric cytology can be used as a rapid test to establish the diagnosis of H pylori infection at the time endoscopy is performed, enabling the endoscopist to start treatment with immediate effect.