Imprint cytology: a simple, cost effectiveness analysis for diagnosing Helicobacter pylori, in west of Iran

BACKGROUND: This study was to determine the sensitivity, specificity, positive predictive value (PPV), negative predictive values (NPV) and agreement between two methods of the stained gastric imprint cytology smears and stained gastric specimen biopsy mucosal methods for detection of H. pylori. METHODS: Air-dried imprint smears of gastric biopsies from 330 patients were stained by the Grunwald-Giemsa method in the endoscopy suite and examined for H. pylori, providing results within minutes. The grade of H pylori infection was documented. The same biopsy was processed and stained with H&E and Grunwald-Giemsa stains, and reviewed by two different pathologists blind to the imprint cytology results. RESULTS: Ninety-four of the 238 patients were male with a mean age of 46 (±16.4) years. Based on histology, the H. pylori prevalence was very high at 77.87% and according to cytology H.Pylori prevalence was high at 75.45% in this region our country. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 96.88% and 90.12%, respectively. The PPV and NPV were 96.88% and 90.12%, respectively. The agreement between two diagnostic methods was 95.26% which confirms reliability of imprint cytology method for ion of H.pylori detection. CONCLUSION: Gastric imprint smears stained with Grunwald-Giemsa method is a rapid and cost effective method in addition to histology for detecting H. pylori in patients undergoing upper gastrointestinal endoscopy and biopsy. It does not require any additional biopsy.