Retrospective analysis of discordant results between histology and other clinical diagnostic tests on helicobacter pylori infection

Table 1 Gastric biopsy cases with ancillary stains

Ancillary stains	Total cases	H. pylori positive	H. pylori negative
WS only	1199	333	866
IHC only	81	20	61
WC/IHC	60	13	47
H&E only	56	26	30
Total	1396	392	1004

WS: Warthin-Starry stain; IHC: Immunohistochemistry stain; H. pylori: Helicobacter pylori; H&E: Hematoxylin and eosin stain.

Table 2 Concordance rate between histology and three other Helicobacter pylori tests

Other H. pylori test	CLO test	SA test	H. pylori culture
Total cases	528	306	562
H. pylori positive cases	104	66	145
H. pylori negative cases	424	240	417
H. pylori positivity rate	19.8%	21.5%	25.8%
Concordance cases	505	282	492
Discordance cases	23	24	70
Concordance rate with histology	95.6%	92.1%	87.5%

H. pylori: Helicobacter pylori; CLO test: Campylobacter-like organism (rapid urease test); H. pylori culture: Helicobacter pylori culture.

Table 3 Assessment of concordance between histology and rapid urease test

	CLO test positive	CLO test negative	Total
Histology positive	95	14	109
Histology negative	9	410	419
Total	104	424	528

CLO test: Campylobacter-like organism (rapid urease test).

Table 4 Assessment of concordance between histology and stool antigen test

	SA positive	SA negative	Total
Histology positive	55	13	68
Histology negative	11	227	238
Total	66	240	306

SA: Stool antigen test.

Table 5 Assessment of concordance between histology and Helicobacter pylori culture

	H. pylori Culture positive	H. pylori Culture negative	Total
Histology positive	145	70	215
Histology negative	0	347	347
Total	145	417	562

H. pylori culture: Helicobacter pylori culture.

Table 6 Discrepant cases with negative histology but positive rapid urease test or stool antigen test

Cases #	No. of biopsy specimens	Histology test results		Clinical tests		Treated for H. pylori
		WS/IHC	On PPI/Antibiotics when biopsied	Pos. Clinical Tested	On PPI/Antibiotics when tested
1	3	Neg/Neg	NA	CLO	NA	Yes
2	2	Neg/Neg	NA	CLO	NA	Yes
3	3	Neg/Neg	NA	CLO	NA	NA
4	2	Neg/Neg	NA	CLO	NA	NA
5	2	Neg/Pos	No	CLO	No	No
6	2	Neg/Neg	Yes1	SA	Yes1	Yes
7	1	Neg/Neg	No	SA	Yes1	Yes
8	M	NP/Neg	Yes2	SA	No	Yes
9	3	Neg/Neg	Yes2	SA	No	Yes
10	M	Neg/Pos	Yes1	SA	Yes1	Yes
11	4	Neg/Pos	Yes1	SA	Yes1	Yes
12	3	NP/Neg	No	SA	No	No
13	M	Neg/Neg	Yes1	SA	No	No
14	2	NP/Neg	Yes1	SA	No	Yes
15	1	NP/Neg	Yes2	SA	No	Yes
16	2	Neg/Pos	Yes1	SA	No	Yes

¹PPI only.

²PPI and antibiotics.

WS: Warthin-Starry stain; IHC: Immunohistochemistry; H. pylori: Helicobacter pylori; CLO: Campylobacter-like organism (rapid urease test); SA: Stool antigen test; PPI: Proton pump inhibitor; NA: Not available; Neg: Negative; Pos: Positive; M: Multiple (6 fragments and up).