Objective Visual Analog Scale for Biopsy Diagnosis of Helicobacter pylori Infection in Clinical Practice.
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers
/ analysis
Biopsy
Child
Child, Preschool
Female
Gastritis
/ metabolism
Gastroscopy
Helicobacter Infections
/ metabolism
Helicobacter pylori
/ isolation & purification
Humans
Immunohistochemistry
Interferon Regulatory Factors
/ analysis
Male
Middle Aged
Plasma Cells
/ chemistry
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Stomach
/ chemistry
Young Adult
Journal
The American journal of surgical pathology
ISSN: 1532-0979
Titre abrégé: Am J Surg Pathol
Pays: United States
ID NLM: 7707904
Informations de publication
Date de publication:
01 05 2021
01 05 2021
Historique:
pubmed:
4
2
2021
medline:
11
5
2021
entrez:
3
2
2021
Statut:
ppublish
Résumé
Historic and current pathology society guidelines recommend using visual gestalt to identify substantial inflammatory cell infiltrate in Helicobacter pylori gastritis, but these scales were subjectively designed. This study aims to objectively investigate the density of inflammation that justifies additional workup for H. pylori infection. We retrospectively identified 2 patient cohorts who had undergone endoscopy with gastric biopsies; 1 with H. pylori infection (n=66), confirmed with a positive stool antigen test and/or Campylobacter-like organism test, and 1 without infection (n=81). Antral and body biopsies were selected from each case, if available, and stained with MUM-1 to highlight mucosal plasma cells. Digital analysis was performed to calculate the number of plasma cells/mm2, termed the "inflammatory score" (IS). Patients with H. pylori infection had an average of 1289 plasma cells/mm2 in the antrum and 835 plasma cells/mm2 in the body, compared with 346 plasma cells/mm2 in the antrum and 178 plasma cells/mm2 in the body in patients without infection. IS cut-off values for a positive infection were 714 plasma cells/mm2 in the antrum and 316 plasma cells/mm2 in the body, with high sensitivities and specificities in both the antrum (92%, 92%) and body (85%, 84%), respectively. A visual analog scale was created to provide a histologic correlate of the observed IS ranges and cut-offs. This practical and objective scale is associated with a high sensitivity and specificity for diagnosing H. pylori infection and justifies moving away from upfront universal H. pylori testing in routine clinical practice.
Identifiants
pubmed: 33534221
doi: 10.1097/PAS.0000000000001681
pii: 00000478-202105000-00008
doi:
Substances chimiques
Biomarkers
0
Interferon Regulatory Factors
0
interferon regulatory factor-4
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
672-679Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.
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