Comparison of Helicobacter pylori Antibody Detection in Stool with other Diagnostic Tests for Infection

Ceken, Nihan;Yurtsever, Sureyya Gul;Baran, Nurten;Alper, Emrah;Buyrac, Zafer;Unsal, Belkis

  • Published : 20110400

Abstract

For detection of Helicobacter pylori, bacterial culture and histopathological examination are invasive in nature, whereas the fast urease test and urea breath test are non-invasive and indirect methods of detection. Stool antibody tests and polymerase chain reaction (PCR) to detect genomic DNA are serological methods, which are preferred to invasive examinations. Our aim was to assess diagnostic specifity and sensitivity of stool antibody tests, with histopathological examination as the golden standard and to compare results with fast urease test findings. Biopsy samples of patients in the study were evaluated as examples of invasive methods, and also stool antibody screening were made (HpSA). When urease and HpSA test results were compared with histopathological results, sensitivity and specificity of urease test were 62.2% and 100%, respectively, and 68.9% and 100% for the HpSA test. General accuracy was 80% and 81%, respectively , positive predictive value 100% with each and negative predictive values 66.1% and 67.2% . The differences were not statistically significant, and the confidence intervals were approximately in the same range. Thus results obtained with biopsy urease and HpSA tests were generally similar to those obtained by histopathological examination. A review of national and international literature showed similar findings.

Keywords

References

  1. Blaser MJ (2000). Helicobacter pylori and related organisms. Principles and Practice of Infectious Diseases, 2285-93. Edited by Mandell GL, Douglas RG, Bennet JE. Eds. New York: C. Livingstone.
  2. Blaser MJ (2005). Helicobacter pylori and other gastric Helicobacter species. Principles of Practice of Infectious Diseases, 2557-67. Edited by Mandell GL, Bennett JE, Dolin R. 6th ed. Philadelphia: Churchill Livingstone.
  3. Cutler AF, Havstad S, Ma CK, et al (1995). Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection. Gastroenterology, 109, 136-41. https://doi.org/10.1016/0016-5085(95)90278-3
  4. Dalgic B (2003). Cocukluk caginda gastrit ve peptik ulser. Klinik Pediatri, 2, 26-32.
  5. Dimson SB (1971). Transit time related to clinical findings in children with reccurent abdominal pain. Pediatrics, 47, 666-74.
  6. Fiedorek SC, Malaty HL, Evans DL, et al (1991). Factors influencing the epidemiology of Helicobacter pylori in children. Pediatrics, 88, 578-82.
  7. Gurkan F (2000). Helicobacter pylori taramasi. Katki Pediatri Dergisi, 21, 384-7.
  8. Ishihara S Kaji T, Kawamura A, et al (2000). Diagnostic accuracy of a new non-invasive enzyme immunoassay for detecting Helicobacter pylori in stools after eradication therapy. Aliment Pharmacol Ther, 14, 611-4. https://doi.org/10.1046/j.1365-2036.2000.00736.x
  9. Kato M, Asaka M, Saito M, et al (2000). Clinical usefulness of urine-based enyzme-linked immunosorbent assay for detection of antibody to Helicobacter pylori: A collaborative study in nine medical institutions in Japan. Helicobacter, 2,109-19.
  10. Lehours P, Yilmaz O (2007). Epidemiology Helicobacter pylori infection. Helicobacter, 12, 1-3.
  11. Logan R, Walker MM (2002). Helicobacter pylori infeksiyonnun epidemiyolojisi ve tanısı. ABC of the uppergastrointestinal tract p.16-8. Edited by Logan R, Haris A, Misiewicz JJ, Baron JH. İstanbul: Ladin Yayıncılık.
  12. Makrishathis A, Pasching E, Schtze K (1998). Detection of Helicobacter pylori in stool specimens by PCR and antigen enzyme immunoassay. J Clin Microbiol, 36, 2772-4.
  13. Plebani M, Basso D (1999). Diagnosis of Helicobacter pylori infection by HpSA test. Lancet 2, 354(9185), 1210. https://doi.org/10.1016/S0140-6736(05)75419-2
  14. Tuncer R, Iskit SH, Okur H, et al (2004). Kronik karın agrili cocuklarda H.pylori tanisinda kullanilan testlerin etkinligi. Turkiye Cocuk Cerrahisi Dernegi 2004 Yili kongresi P - 57.
  15. Salyers AA, Whitt DD (2002). Helicobacter pylori, a resourceful gastric pathogen. In: Bacterial Pathogenesis. A molecular approach. Second edition. Washington DC: American Society for Microbiology 339-51.
  16. Suerbaum S, Michetti P (2002). Helicobacter pylori infection. N Eng J Med, 347,1175-86. https://doi.org/10.1056/NEJMra020542
  17. Vahil N, Affi A, Sundaram M, et al (2000). Prospective blinded trial of a fecal antigen test for the detection of Helicobacter pylori infection. Am J Gastroenterol, 95, 1699-701.
  18. Ozdemir M, Baykan M (2005). Dispeptik hastalarda H.pylori infeksiyon tanısında H.pylori gaita antijen tanı değerinin incelenmesi. Genel Tıp Dergisi, 15, 65-70.
  19. Vaira D, MalfertheinerP, Megraud F, et al (1999). Diagnosis of Helicobacter pylori infection with a new non-invasive antigen-based assay. Lancet, 354, 30-3. https://doi.org/10.1016/S0140-6736(98)08103-3
  20. Wissniewska M, Nilsson HO, Bak-Romanniszyn L, et al (2002). Detection of specific Helicobacter pylori DNA and antigens in stool samples in dyspeptic patients and healthy subjects. Microbiol Immun, 46, 657-65. https://doi.org/10.1111/j.1348-0421.2002.tb02749.x
  21. Vakil N, Affi A, Robinson J, et al (2000). Prospective blinded trial of a fecal antigen test for he detection of Helicobacter pylori infection. Am J Gastroenterol, 95, 1699-701.
  22. Vandenplas Y (1999). Helicobacter pylori infection. Clin Microbiol Infect, 5, 1-11.
  23. Versalovic J, Fox JG (2003). Helicobacter. Manual of Clinical Microbiology 8th ed, 915-28. Edited by Murray PR, Baron EJ, Pfaller MA, Jorgensen JH, Yolken RH.Washington DC: American Society for Microbiology.
  24. Wu I-C, Ke H-L, Lo Y-C, et al (2003). Evaluation of a newly developed Office-based stool test for detecting Helicobacter pylori: An extensive Pilot study. Hepato-Gastroenterology, 50, 1761-5.