Additional Endoscopic Corpus Biopsy May Increase Accuracy of Helicobacter Pylori Detection

Background: This study was designed to determine if it is important to add corpus biopsies to the routine antral ones for identification of H. pylori, especially in case of gastric atrophy and/or intestinalmetaplasia. Methods: This is a prospective multicenter study including three hundred and twenty eight patients with gastritis from June 2014 through Dec.2015. Endoscopic mucosal biopsies from the gastric antrum and corpus were submitted to histological examination according to updated Sydney system for detection of H.pylori. Results: In the study period, a total 328 consecutive patients underwent upper gastrointestinal endoscopy for different reasons. The mean age of the patients was 39+12 years; 183 (55.7%) were women. H pylori was found positive in 193 (58.8%) of the patients. Combined antral and corpus biopsies increased the result by 20.8% compared to antral biopsies alone and 4.5% compared to corpus biopsies alone. 20.8% of patients infected with H pylori would have been misdiagnosed if testing was based onantrum alone and not combined with corpus. Atrophy and intestinal metaplasia were found in 101(30.8%) and 17(5.2%) of our patients, respectively. Atrophic gastritis was significantly more often in the antrum than the corpus (29.2 VS 11.9%, respectively, p< 0.05). Patients with only positive corpus biopsies showed more incidences of both atrophy and intestinal metaplasia. Detection rates of H pylori decreased as more as atrophy increased regardless of biopsy site. Conclusion: This study clarified that additional gastric corpus biopsy to the antral one increases the sensitivity to detect H pylori infection especially if associated with gastric atrophy.