Is rapid urease test reliable as histopathological evaluation for Helicobacter pylori Infection- A prospective study?

Background: Helicobacter pylori (H.pylori) is a widespread pathogen causing gastroduodenal damage.The Rapid Urease Test (RUT), a quick, affordable, and simple diagnostic tool, is commonly used to detect urease presence in the gastric mucosa.Given H. pylori's global prevalence, accurate diagnosis is crucial.Our study aims to compare the accuracy of RUT with histopathology, and the effectiveness of Hematoxylin & Eosin (H&E) versus Modified Giemsa (MG) staining in detecting H. pylori.Materials and Methods: In this study conducted from October 2022 to January 2024, the Rapid Urease Test (RUT) results were juxtaposed with the histopathological findings of gastric biopsies.These biopsies were undertaken in the Department of Pathology at MMIMSR.The biopsy samples underwent routine tissue processing and were subsequently stained with H&E and MG.The histological analysis was carried out following the guidelines of the modified Sydney system.Results: Gastric biopsies from 105 patients were analyzed using RUT, Hematoxylin & Eosin (H&E), and MG staining.The results showed that 59.05% of patients tested positive for H. pylori using RUT, and 60% tested positive on histopathology.The sensitivity and specificity of RUT were 82.54% and 76.19%, respectively, with a significant association between RUT and Histology (p-value <0.0001, Chi-square test =35.95).The sensitivity and specificity of H&E staining were 79.37% and 100.00%, respectively. Conclusion:The study concluded that RUT is a reliable initial detection method for H. pylori, but negative results should be confirmed with histological evaluation using H&E and MG stain.