Conventional Upper-Intestinal Endoscopy Value in Predicting Histopathological Features Related to Helicobacter pylori Infection: A Comparative Study Between Endoscopy and Histology Findings Among Dyspeptic Outpatients in Cameroon.

Background: The aim of this study was to determine the prevalence of Helicobacter pylori in relation to endoscopic and histopathology features and to find out the correlation between the two diagnostic methods.

Methods: Gastroduodenal biopsy specimens were collected from 475 dyspeptic outpatients who attended the Department of Gastroenterology in reference hospitals in Cameroon. The study was approved by the local and national ethical committees on human health research in Cameroon. Informed consent was obtained from all subjects before inclusion. A full endoscopic evaluation of the esophagus, stomach, and duodenum was performed in all patients. Biopsy samples were collected from each participant for H. pylori detection using histology and rapid urease test. Hematoxylin and eosin stain was used for histomorphological features examination.

Results: Helicobacter pylori was found in 57.89% of the dyspeptic outpatients. In endoscopy, 40.00% of our patients had gastritis, of which 58.42% were H. pylori infected. Erythematous-exudative gastritis was the most common gastritis type (46.00%) and also the most common gastritis type found among H. pylori-infected subjects (43.1%). Histologically, chronic gastritis was the most common histological finding recorded (46.11%) and the abnormality with the highest rate of H. pylori infection (44.00%). The highest rate of H. pylori infection was found among patients with moderate neutrophil activity (46.18%). Gastritis types were significantly correlated with histological findings (p = 0.016). Endoscopic findings were significantly correlated with neutrophil activity (p = 0.0005).

Conclusion: The current poor correlation observed between endoscopy and histology findings emphasizes the role of histology in the diagnosis of gastroduodenal pathological features in dyspeptic patients in our context.