Background: The aim of this study was to determine whether an antral biopsy alone represents an adequate tissue sample to diagnose the presence of <i>Helicobacter pylori</i> on the mucosa. Furthermore, we explored the conditions associated with the presence of <i>H. pylori</i> in the corpus.
Methods: Consecutive patients who underwent an upper
gastrointestinal endoscopy at a single centre between
January 1995 and May 1997 were studied. Biopsies were
taken at each endoscopy to assess the presence of <i>H. pylori</i>: two antral and two corpus biopsies for histological examination and one antral and one corpus biopsy for the CLO test.
Results: A total of 620 patients underwent an upper gastrointestinal endoscopy, 307 (50%) were <i>H. pylori</i> infected. In 80% of the endoscopies there was total agreement between the performed biopsy tests. The addition of corpus biopsies increases the diagnostic yield by 10% in <i>H. pylori</i>-positive patients. Patients with only corpus infection more often showed atrophy and intestinal metaplasia compared with patients with both antral and corpus infection, 37 vs 20%, respectively (OR 2.2, 95% CI 1.1-4.4).
Conclusion: One biopsy from the antrum or corpus seems to be inadequate to diagnose the presence of <i>H. pylori</i> on the mucosa. Patients with an infection exclusively in the corpus more often had worse mucosa pathology.