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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 JY, Leja M. Who Could Be Blamed in the Case of Discrepant Histology and Serology Results for Helicobacter pylori Detection? Diagnostics (Basel) 2022; 12:133. [PMID: 35054298 PMCID: PMC8774513 DOI: 10.3390/diagnostics12010133] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/11/2022] Open
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 serology-negative/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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Affiliation(s)
- Sabine Skrebinska
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Faculty of Residency, Riga Stradins University, LV-1007 Riga, Latvia
| | - Francis Megraud
- French National Reference Centre for Campylobacters and Helicobacters, Bacteriology Laboratory, Bordeaux University Hospital, 33076 Bordeaux, France; (F.M.); (C.A.)
- Campus of Carreire, INSERM U1053 BaRITOn, University of Bordeaux, 33000 Bordeaux, France
| | - Ilva Daugule
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
| | - Daiga Santare
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
| | - Sergejs Isajevs
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Academic Histology Laboratory, LV-1073 Riga, Latvia
| | - Inta Liepniece-Karele
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Academic Histology Laboratory, LV-1073 Riga, Latvia
| | - Inga Bogdanova
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Academic Histology Laboratory, LV-1073 Riga, Latvia
| | - Dace Rudzite
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
| | - Reinis Vangravs
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
| | - Ilze Kikuste
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
| | - Aigars Vanags
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
| | - Ivars Tolmanis
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
| | - Selga Savcenko
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Riga East University Hospital, LV-1038 Riga, Latvia
| | - Chloé Alix
- French National Reference Centre for Campylobacters and Helicobacters, Bacteriology Laboratory, Bordeaux University Hospital, 33076 Bordeaux, France; (F.M.); (C.A.)
- Campus of Carreire, INSERM U1053 BaRITOn, University of Bordeaux, 33000 Bordeaux, France
| | - Rolando Herrero
- Agencia Costarricense de Investigaciones Biomedicas, Fundación INCIENSA, San Jose 2250, Costa Rica;
- International Agency for Research on Cancer, Early Detection, Prevention and Infections Branch, 69372 Lyon, France;
| | - Jin Young Park
- International Agency for Research on Cancer, Early Detection, Prevention and Infections Branch, 69372 Lyon, France;
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine & Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia; (I.D.); (D.S.); (S.I.); (I.L.-K.); (I.B.); (D.R.); (R.V.); (I.K.); (A.V.); (S.S.); (M.L.)
- Digestive Diseases Centre “GASTRO”, LV-1079 Riga, Latvia;
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