AI Article Synopsis
- A reliable test is essential for diagnosing infections, with histologic examination being a key method alongside tests like the CLO test and stool antigen test.
- There can be occasional discrepancies between histopathology results and other diagnostic tests, which can impact clinical management.
- This study analyzed pathology reports from gastric biopsies over five years to investigate reasons for discrepancies, focusing on cases where histology was negative but other tests were positive, finding that medication like proton pump inhibitors might have influenced the results.
Article Abstract
Background: A reliable test is essential for diagnosing () infection, and crucial for managing -related diseases. Serving as an excellent method for detecting infection, histologic examination is a test that clinicians heavily rely on, especially when complemented with immunohistochemistry (IHC). Additionally, other diagnostic tests for , such as the rapid urease test (CLO test) and stool antigen test (SA), are also highly sensitive and specific. Typically, the results of histology and other tests align with each other. However, on rare occasions, discrepancy between histopathology and other diagnostic tests occurs.
Aim: To investigate the discordance between histology and other tests, the underlying causes, and the impact on clinical management.
Methods: Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018. Reports were included in the study only if there were other tests within seven days of the biopsy. These additional tests include CLO test, SA, and culture. Concordance between histopathology and other tests was determined based on the consistency of results. In instances where histology results were negative while other tests were positive, the slides were retrieved for re-assessment, and the clinical chart was reviewed.
Results: Of 1396 pathology reports were identified, each accompanied by one additional test. The concordance rates in detecting infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments. 117 discrepant cases were identified. Only 20 cases (9 with CLO test and 11 with SA) had negative biopsy but positive results in other tests. Four cases initially stained with Warthin-Starry turned out to be positive for with subsequent IHC staining. Among the remaining 16 true discrepant cases, 10 patients were on proton pump inhibitors before the biopsy and/or other tests. Most patients underwent treatment, except for two who were untreated, and two patients who were lost to follow-up.
Conclusion: There are rare discrepant cases with negative biopsy but positive in SA or CLO test. Various factors may contribute to this inconsistency. Most patients in such cases had undergone treatment.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10921152 | PMC |
| http://dx.doi.org/10.4253/wjge.v16.i2.64 | DOI Listing |
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