Detection of H. pylori at Distal Esphageal Mucosa by a Novel Multiplex PCR Assay

Abstract

Purpose: Many factors have been reported to affect the ability to identify H. pylori in clinical practice. These include the type of tests used, the experience of the pathologist, the number of biopsy samples, and the location from which they were taken. H. pylori is a highly motile and most commonly lives in the mucous layer of the gastric epithelium. Motility, by way of flagella, enables the organism to easily travel within the mucous layer. H. pylori in the esophagus is found only in areas of Barrett's esophagus. In order to determine the prevalence of Helicobacter pylori infection at antral gastric and esophageal mucosa and its correlation with the multiplex PCR findings, a prospective study was performed with a novel one-step multiplex PCR method in 102 patients with dyspepsia symptoms. Methods: This study was performed in 102 patients with dyspepsia symptoms undergoing endoscopy in Evanston Northwestern Healthcare. Six specimens, 2 from the corpus, 2 from the antrum and 2 from the distal esophageal, were collected from each patient by endoscopy for extracted DNA and was performed the one-step multiplex PCR. Results: Helicobacter pylori was found on the biopsy specimens of the gastric antrum/ corpus and distal esophagus in 43% (44/102) and 32% (33/102), respectively. The combinative positive results of the three locations were achieved 53%. Conclusions: Our results indicate that the H. pylori could live in the distal esophagus since some cases have positive H. Pylori in the esophagus but not in the stomach. (Although false positive results may be obtained, the samples of distal esophagus due to contamination from the gastric antrum/corpus in the process of endoscopy or because of the hyper sensitivity of the PCR method.) Therefore multiple biopsies, especially the specimens from distal esophagus may be needed for the diagnosis of H. pylori infection in some situation.