A PCR Assay of Gastric Biopsy Specimens for the Diagnosis of Helicobacter pylori Infection in Children

Seo, Jeong Wan; Lee, Mi Ae; Han, Woon Sup

Abstract

PURPOSE: The aim of this study was to evaluate the usefulness of PCR using ureC primer in the gastric biopsy specimens for the diagnosis of Helicobacter pylori (H. pylori) infection in children.
METHODS
We have assessed prospectively 82 patients (age range 1-15 years) who underwent esophagogastroduodenoscopy (Olympus EVIS XQ 200 or p230, Japan) for 15 months. At least three biopsy specimens were taken from the antral mucosa within 2cm of the pylorus. We performed histological detection with modified Giemsa stain, CLO test (Delta West Pty Ltd, Australia) for rapid urease test and PCR using ureC primer. H. pylori positivity was defined as the concordance of two tests. The patients with only one positive test were defined as undetermined cases.
RESULTS
Seventeen of the 82 patients were H. pylori positive and 52 patients were H. pylori negative by definition. Of the 17 patients, 15 were found to be positive by all three tests, 2 were found to be positive by two tests. Abnormal endoscopic findings in H. pylori positive patients (82.4%) was significantly higher than H. pylori negative patients (50.0%) (P<0.05). Diagnostic sensitivity, specificity, positive predictive value, negative predictive value and efficiency of PCR in gastric biopsy specimens were 94.1%, 100%, 100%, 98.1%, 98.7% and same as CLO test, respectively. Those of endoscopic nodularity was 58.8%, 100%, 100%, 88.1% 89.9%.
CONCLUSION
These findings suggest the PCR assay using the ureC gene in gastric biopsy specimens is sensitive and rapid for the diagnosis of H. pylori infection in children. But, in this study diagnostic sensitivity and specificity of PCR assay were the same as the CLO test.