To the Editor.— I share the views of Greenberg and Bank1 that when considering the etiopathological role of Helicobacter pylori in nonulcer dyspepsia one needs to take into account the age of the patients surveyed. However, I fear that the authors might have underestimated the true prevalence of H pylori colonization in their study population by using a single antral biopsy urea broth test. The biopsy urea broth test has recently been compared in a pilot study2 with a modified technique, cytological brushing urea broth test, and histologic examination used in our unit and has been shown to underestimate H pylori colonization by 15% (85% sensitivity of biopsy urea broth test and 100% sensitivity of cytologic brushing urea broth test, respectively). The false-negative rate has increased to about 20% in a subsequent larger study (unpublished results). No mention has been made in the article by Greenberg and Bank
Ching CK. Underestimation of Helicobacter pylori Infection Rate by Biopsy Urea Broth Test. Arch Intern Med. 1991;151(7):1462. doi:10.1001/archinte.1991.00400070200037
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