DIAGNOSTIC EFFICACY OF STOOL ANTIGEN TEST (HPSA), CLO TEST AND SEROLOGY FOR THE DETECTION OF HELICOBACTER PYLORI INFECTION

R. Baqai, H. Qureshi, G., Arian, I. Mehdi

Abstract


Background: The diagnosis of Helicobacter pylori infection was initially being made through invasive methods but now non invasive methods have been developed to make the diagnosis easier.  The present study was done to evaluate the diagnostic efficacy of a two non invasive tests i.e. Helicobacter pylori  Stool antigen test  (HpSA) and Helicobacter pylori IgG serology with an invasive method i.e. Campylobacter like organism (CLO) gel test. Methods. The study was conducted in the gastroenterology unit of Pakistan Medical Research Council Research Centre Karachi. Adult patients with gastroduodenal disease were selected for study and their medical history was recorded. Endoscopy was done on all patients and the antral biopsy sample was tested for  H.pylori  using CLO test. Serology (IgG) was done elsewhere using ELISA and titers of over 50 units were recorded as positive. HpSA was done  to determine the presence of H.pylori antigen in stool. Results.  Out of  43  patients  34 (79%) were males and  9 (21%) females. The main presenting symptom was epigastric pain in 74 % cases. Although H.pylori IgG antibody titers of over 50 were taken as positive but for this study titres of over 100 were taken as significant for comparison with other tests . CLO test was  positive in 26 (60.5%) cases, H. Pylori antibody titers  of over 100 IU were  present  in 33 (76.7%) cases  and HpSA in 21 (48.8 %). Using  CLO test as the gold standard the sensitivity of serology was 81 % and that of HpSA 65% with a 29% and 76 % specificity respectively. Conclusion. In our setting CLO test is still the best diagnostic test  for H. Pylori detection. Both non invasive tests i.e. serology and stool HpSA are less sensitive than CLO but amongst each other both are equally sensitive.

Keywords: Helicobacter Pylori,  Stool Antigen Test, Serology


Full Text:

PDF

References


Vaira D, Malfenthiern P, Megaud F, Axon ATR., Deltene M, Hirschl AL. Diagnosis of Helicobacter pylori infection with a new non-invasive antigen based assay. Lancet 1999; 354:30-33

Qureshi H, Ahmed W, Syed S. Helicobacter pylori clearance and its eradication in duodenal ulcer patients J Pak Med Assoc 1995; 45:2-5

Qureshi H, Ahmed W, Zuberi SJ, Kazi JI. Use of CLO in the detection of Helicobacter pylori infection and its correlation with histological gastritis J Pak Med Assoc 1992 42: 292-94

Wotherspoon AC, Hidelgo OC, Falzon M.P,.Isaacsan P.G. Helicobacter pylori associated gastritis and primary B cell lymphoma Lancet 1993;338:1175-6

Ni YH, Lin JT, Huang SF,Yang JC, Chang MH. Accurate diagnosis of Helicobacter pylori infection by stool antigen and 6 other currently available tests in children J.Pediatr 2000;136:823-7

Ho J, Lui I, Mettnew MT, Lam SK. A study on the correlation of duodenal ulcer healing with Campylobacter like organism J.Gastro Hepato 1986;1;69-74

Gill HH, Shankaran MP. Antigen related prevalence of Helicobacter pylori antibodies Indian J Gastro 1994;13:92-4

Kazi JI, Arian GM. Helicobacter pylori infection. Different methods of identification Pak J Gastroenterology1992;6:5-7

Julasz M, Pronai I, Zagoni T. Comparison of various methods in the detection of Helicobacter pylori infection. Orv Heth 2000;141:911-4

Oderdo G, Rapa A, Roncli B, Lerrro P, Partore M.,et al. Detection of Helicobacter pylori in stool samples by non invasive antigen enzyme immunoassay in children multicentre Italian study. Br Med J 2000;320:347-348

Haq G, Ahmed W, Kazi JI. Qureshi H, Zubeir SJ. Can diagnosis of Helicobacter pylori be rapid and yet sensitive J Pak Med Assoc 1999 ;49:103-4

Kazi JI, Sirrrah R, Zaman V, Jaffery NA, Alam SM, et al. Ultra structural studies of Helicobacter pylori associated gastritis. J of Pathology 1990;161:65-70

Arian GM, Kazi JI, Ahmed W, Zuberi SJ. Immunofluorescence titres in H.pylori J Pak Med Assoc 1995;45:255-8

Makristathis A, Barausch W, Pasching E. Two enzyme immunoassay and PCR for detection of Helicobacter in stool specimens from Pediatric Patientss before and after eradication therapy. J Clim Micro1998;36:2772-4

Culter AF, Prasad VM, Santogde P. Four year trends in Helicobacter IgG serology following successful eradication Am J Med 1998;105:18-20

Puspok A, Bakos S, Oberhuber G. A new non-invasive method for detection Helicobacter pylori: validity in the routine clinical setting Eup J Gastro Hepat 1999;11:113 -42

Calvel H, Feu F, Forne M, Montserrae H, Elizala J. The evaluation of new immunoenzyme analysis for the detection of Helicobacter pylori infection in stool samples Gastroenter.Hepatol 1999;22:270-2

Braden B, Posselt HG, Ahren P, Kitz R, Dietrich CF, Caspary WF. New immunoassay in stool provides an accurate and non-invasive diagnostic method for Helicobacter pylori screening in children Pediatrics 2000;106:115-7

Metz DC. Stool testing for Helicobacter pylori: infection. Yet another non invasive alternative Am. J. Gastro 2000; 95:546-8

Trevasan I, Sartori S, Ggalvani S, Rossi MR, Ruina M., Chianenti C, et al. Evaluation of a new enzyme assay for detecting Helicobacter pylori in feaces, a prospective pilot study Am J Gastro 1999;94:1830-3

Forne M, Dominguez J, Fernandez BJ, Esteve M, Gali N, et al. Accuracy of an enzyme immunoassay for the detection of Helicobacter pylori in stool specimen in the diagnosis of infection and post treatment check up. Am J Gastro 2000;95:2200-5

Haq G. One minute urea test. Gut1990;34 :840-7

Manes G, Balzano A, Iaquinto G, Ricci C, Piccirillo MM, Giardullo N, et al. Accuracy of the stool antigen test in the diagnosis of Helicobacter pylori infection before treatment and in patients on Omeprazole therapy. Aliment Pharmacol Ther 2001;15;73-9


Refbacks

  • There are currently no refbacks.


Contact Number: +92-992-382571

email: [jamc] [@] [ayubmed.edu.pk]