Accuracy of Helicobacter pylori serology in two peptic ulcer populations and in healthy controls

作者：Lindsetmo Rolv Ole^*; Johnsen Roar; Eide Tor Jac; Gutteberg Tore; Husum Hanne Haukland; Revhaug Arthur

来源：World Journal of Gastroenterology, 2008, 14(32): 5039-5045.

DOI：10.3748/wig.14.5039

• C14-urea breath test
• gastric inflammation
• helicobacter pylori serology
• peptic ulcers
• test characteristics

AIM: To estimate the test characteristics of Helicobacter pylori (H pylori) serology and of C14-urea breath test (C14-UBT) in two different peptic ulcer populations and in community controls. Second, the aim was to explore the association between the level of H pylori IgG antibodies and severity of inflammation as to active peptic ulceration in the same populations.
METHODS: Vagotomized (n = 83), medically treated peptic ulcer patients (n = 73) and one reference group of community controls (n = 88) were gastroscoped. H pylori status was determined by histology, bacterial growth, C14-UBT and serology. Based on the updated Sydney System, cumulative scores from biopsies from the prepyloruos, incisura angularis, corpus and fundus were calculated.
RESULTS: The prevalence of H pylori infection varied from 70% to 79%. The C14-UBT had high accuracy compared to the serology test. The sensitivity of the serology test was good, but the specificity was low (41%-71%). The association between H pylori IgG antibodies and scores of gastric mucosal inflammation and current or previous peptic ulcer were weak.
CONCLUSION: The accuracy of C14-UBT to diagnose Hpylori infection was good, and the clinical utility of a negative H pylori serology test was substantial, while the gain in clinical information of a positive test was meagre. Positive H pylori titres could not distinguish between subjects with or those without active peptic ulceration.

• 出版日期2008-8-28