Factors for improving the diagnostic efficiency of the rapid urease test from the gastric corpus

Objective: This study aimed to evaluate the optimal biopsy site for Helicobacter pylori detection by comparing the results of rapid urease test (RUT) between the gastric corpus and the antrum.Methods: A biopsy specimen from each subject was obtained from the corpus and from the antrum. For each subject, the two specimens were separately immersed in two different RUT kits. Positive reaction times were measured at 20minutes and 1, 3, and 24hours. If either of the two RUT kits showed a positive reaction, H. pylori infection was confirmed.Results: A total of 310 H. pylori-infected subjects were eligible for study inclusion. Compared with the antrum, positive RUT reaction times in the corpus were shorter when the degree of gastric atrophy was moderate or severe (p=.001 and p<.001, respectively). A multivariate analysis revealed that the factors resulting in a faster positive RUT reaction in the corpus were age 50 years (odds ratio [OR]=1.84; 95% confidence interval [CI]=1.10-3.08; p=.021) and severe gastric atrophy (OR=2.41; 95% CI=1.13-5.13; p=.023). Also, severe gastric atrophy was an independent factor associated with positive RUT reaction only in the corpus (OR=5.12; 95% CI=1.55-16.88; p=.007).Conclusions: In subjects aged 50 years or with severe gastric atrophy, biopsy of the corpus mucosa optimized the efficiency of H. pylori detection through a faster positive RUT reaction.