Comparison of gastric juice soluble triggering receptor expressed on myeloid cells and C-reactive protein for detection of Helicobacter pylori infection

Abstract

Background and aimTriggering receptor expressed on myeloid cells (TREM-1) is a receptor on phagocytes that is triggered by infectious agents. The soluble form of it (sTREM-1) can be elevated in gastric juice by Helicobacter pylori (H. pylori) infection of gastric mucosa. The aim of this study was to compare the diagnostic values of sTREM-1 and C-reactive protein (CRP) for detection of H. pylori infection in gastric mucosa.MethodsIn this diagnostic accuracy study on cases who underwent endoscopy from March 2015 to July 2016 in Shahid Beheshti Hospital, Kashan, Iran, gastric juice sTREM-1 and CRP concentrations were measured by enzyme-linked immunosorbent assays (ELISA) and their diagnostic values were compared to detect H. pylori infection. Gold standard test was histopathology. Data were entered into SPSS software version 16. Statistical analysis was made by Kolmogorov-Smirnov, Chi-square, Independent-samples t-test, Kruskal-Wallis, Mann-Whitney U, Pearson product-moment correlation, Receiver operating characteristic curve (ROC), Brier score, Nagelkerke R square and scaled reliability test.ResultsOf a total of 160 cases, 81 (50.6%) were H. pylori-positive based on pathology. The level of sTREM-1 in H. pylori-positive patients was significantly higher than H. pylori-negative patients (p=0.000), but no significant difference between CRP concentrations was shown between groups (p=0.7). Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and accuracy of sTREM-1 were 82%, 75%, 3.3, 0.25, 78% and for CRP were 62%, 40%, 1.02, 0.98, 51% respectively for diagnosis of H. pylori infection. True positive and negative rates were 66 (81.5%) and 59 (74.7%) for sTREM-1 and 50 (61.7%) and 31 (39.2%) for CRP. The levels of sTREM-1 and CRP were not significantly different between endoscopic finding groups (p=0.97, p=0.2 respectively).ConclusionDespite CRP, sTREM-1 was a relatively acceptable indicator of H. pylori infection of gastric mucosa.

What Is New in Helicobacter pylori Diagnosis. An Overview

“…In addition to gastric biopsies, molecular tests can be applied to the gastric mucus present on biopsy forceps placed into water or into the RUT gel [ 88 ], and the dual-priming oligonucleotide-based multiplex PCR, performed on CLO ® -test kits, proved to be superior to RUT and histology, in patients with a bleeding peptic ulcer [ 89 ]. Alternatively, molecular tests to detect H. pylori and its susceptibility to antibiotics can be performed on gastric juice [ 90 , 91 , 92 ]. A droplet-digital PCR may also be applied to formalin-fixed, paraffin-embedded gastric tissue to determine the presence of clarithromycin resistance [ 93 ], or by next generation sequencing to determine levofloxacin and tetracycline resistance [ 94 ] ( Figure 2 ).…”

Diagnosis of Helicobacter pylori infection

“…Piroozmand et al explored and evaluated two biomarkers in gastric juice for detection of H. pylori infection by ELISA using histology as the gold standard (81 of 160 cases were positive). The so‐called soluble triggering receptor expressed on myeloid cells (sTREM‐1) showed better performance and higher reliability than C‐reactive protein (CRP) measurement in the gastric juice . The positive and negative rates were 81.5% and 74.7% for TREM 1 vs 61.7% and 39.2% for CRP.…”

“…The so-called soluble triggering receptor expressed on myeloid cells (sTREM-1) showed better performance and higher reliability than C-reactive protein (CRP) measurement in the gastric juice. 33 The positive and negative rates were 81.5% and 74.7% for TREM 1 Another study on a Korean adult population, including 4830 subjects, with H. pylori seropositivity in 3116 cases (64.5%), evaluated the association between serum PG level with different gastric mucosal lesions. They found a decreased PG1/2 ratio, when chronic atrophic gastritis and intestinal metaplasia were present.…”