Comparison of the Diagnostic Values of the 3 Different Stool Antigen Tests for the Noninvasive Diagnosis of Helicobacter pylori Infection

Keşli, Recep; Gokturk, Huseyin Savas; Erbayrak, Mustafa; Karabağlı, Pınar; Terzi, Yüksel

doi:10.2310/jim.0b013e3181f31569

Cited by 26 publications

(12 citation statements)

References 26 publications

(26 reference statements)

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“…Evaluating the results of other studies in Table , we concluded that the sensitivity rates were lower for monoclonal ICA‐based HpSA tests than for EIA‐based HpSA tests. Conversely, in some reports where both test methods (ICT and EIA) were used in the same patient groups, monoclonal ICA‐based test results were higher than those of polyclonal and monoclonal EIA‐based tests . These results are also concordant with the result in our study.…”

Section: Discussionsupporting

confidence: 92%

“…In this study, according to the reference test (histology plus RUT), H. pylori infection was positive in 45.4% of the patients. In the other studies performed in different areas of Turkey with different HpSA tests, the rates [25], 36.9%. The differences in H. pylori positivity between these studies and our study may depend on the presence of risk factors in the investigated populations.…”

Section: Discussionmentioning

confidence: 85%

“…, 57.8%; and by Kesli et al. , 36.9%. The differences in H. pylori positivity between these studies and our study may depend on the presence of risk factors in the investigated populations.…”

Section: Discussionmentioning

confidence: 86%

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Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection

Korkmaz

Keşli²,

Karabağlı

et al. 2013

Helicobacter

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Background Several noninvasive diagnostic tests based on the detection of Helicobacter pylori stool antigen (HpSA) have been developed. The aim of the study was to compare the diagnostic accuracy of 5 HpSA tests—2 monoclonal enzyme immunoassay tests (EIAs: the Premier Platinum HpSA Plus test and Helicobacter pylori Antigen (Hp Ag) test) and 3 rapid immunochromatographic assay (ICA) tests (the ImmunoCard STAT! HpSA test, one step HpSA test, and H. pylori fecal antigen test)—for diagnosing H. pylori infection in adult patients with dyspeptic symptoms before eradication therapy. Materials and Methods A total of 198 patients with dyspeptic symptoms were included in the study. A gastric biopsy was collected for histopathology and rapid urease testing. Stool specimens for HpSA testing were also collected. Patients were considered H. pylori positive if two invasive tests (histological and rapid urease tests) were positive. Results The sensitivity and specificity were 92.2% and 94.4%, respectively, for the Premier Platinum HpSA Plus test; 48.9% and 88.9%, respectively, for the HP Ag test; 86.7% and 88.9, respectively, for the One Step HpSA test; 68.9% and 92.6%, respectively, for the ImmunoCard STAT! HpSA test; and 78.9% and 87%, respectively, for the H. Pylori fecal antigen test. Conclusions The Premier Platinum HpSA Plus EIA test was determined to be the most accurate stool test for diagnosing H. pylori infections in adult dyspeptic patients. The currently available ICA‐based tests are fast and easy to use but provide less reliable results.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 85%

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Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection

Korkmaz

Keşli²,

Karabağlı

et al. 2013

Helicobacter

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“…Different stool antigen tests using poly-or monoclonal antibodies are available. However, these test systems show relatively low sensitivities and specificities of 49 to 92% and 76 to 94%, respectively, as shown in recent studies by Calvet et al, Kesil et al, and Korkmaz et al (15,16,17). While stool antigen is the preferred test for use in children (18), its reliability and predictive value in adults are lower (19).…”

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confidence: 91%

A Novel Line Immunoassay Based on Recombinant Virulence Factors Enables Highly Specific and Sensitive Serologic Diagnosis of Helicobacter pylori Infection

Formichella

Romberg

Bolz

et al. 2013

Clin Vaccine Immunol

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g Helicobacter pylori colonizes half of the world's population, and infection can lead to ulcers, gastric cancer, and mucosa-associated lymphoid tissue (MALT) lymphoma. Serology is the only test applicable for large-scale, population-based screening, but current tests are hampered by a lack of sensitivity and/or specificity. Also, no serologic test allows the differentiation of type I and type II strains, which is important for predicting the clinical outcome. H. pylori virulence factors have been associated with disease, but direct assessment of virulence factors requires invasive methods to obtain gastric biopsy specimens. Our work aimed at the development of a highly sensitive and specific, noninvasive serologic test to detect immune responses to important H. pylori virulence factors. This line immunoassay system (recomLine) is based on recombinant proteins. For this assay, six highly immunogenic virulence factors (CagA, VacA, GroEL, gGT, HcpC, and UreA) were expressed in Escherichia coli, purified, and immobilized to nitrocellulose membranes to detect serological immune responses in patient's sera. For the validation of the line assay, a cohort of 500 patients was screened, of which 290 (58.0%) were H. pylori negative and 210 (42.0%) were positive by histology. The assay showed sensitivity and specificity of 97.6% and 96.2%, respectively, compared to histology. In direct comparison to lysate blotting and enzyme-linked immunosorbent assay (ELISA), the recomLine assay had increased discriminatory power. For the assessment of individual risk for gastrointestinal disease, the test must be validated in a larger and defined patient cohort. Taking the data together, the recomLine assay provides a valuable tool for the diagnosis of H. pylori infection.

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“…compared histology and rapid urease test to monoclonal SAT enzyme immunoassays (EIAs), Premier Platinum HpSA Plus EIA (Meridian Diagnostics Inc, Cincinatti, OH, USA) and H. pylori Antigen test (Dia.Pro Diagnostic Bioprobes Sri, Milano, Italy) and one immunochromatographic assay (Vegal Farmaceutica, Madrid, Spain) for the diagnosis of H. pylori infection in 168 Turkish adults with dyspepsia before eradication therapy. All had a similar specificity of about 92%, but the Premier Platinum EIA had the highest sensitivity at 90% (Table 1) [41]. Falaknazi et al.…”

Section: Noninvasive Testsmentioning

confidence: 99%

Diagnosis of Helicobacter pylori Infection

2011

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While few new methods have been proposed for Helicobacter pylori diagnosis, there are still a number of articles evaluating the current methods and trying to improve their accuracy. Invasive tests EndoscopyAttempts to diagnose Helicobacter pylori infection directly during endoscopy have been made in the past. While the observation of H. pylori per se is usually not possible, indirect evidence of its presence can be found. This year, using standard endoscopy in children, Hidaka et al. [1] were able to show that the absence of regular arrangement of collecting venules at two sites, indicated the absence of H. pylori infection with an excellent sensitivity (100%) and specificity (90%). The respective values for antral nodularity, the usual criterion, were 84% and 100%.Three studies evaluated narrow band imaging (NBI), a technique enhancing the mucosal and capillary patterns of the gastric surface. Three hundred patients were explored with conventional NBI and 5 mucosal patterns were identified, corresponding to different grades of histological gastritis [2]. Magnifying NBI was also used to investigate the changes in gastric mucosal patterns before and 12 weeks after H. pylori eradication. In patients without severe atrophy and intestinal metaplasia (IM), the changes in pit size and density of fine irregular vessels were observed with a perfect sensitivity and specificity. In contrast, no change occurred in patients with severe atrophy and IM, regardless of H. pylori eradication [3]. The authors emphasized that this method predicts histological conditions and pepsinogen levels and may be cost effective in gastric cancer surveillance [4].Confocal laser endomicroscopy, a magnifying endoscopy technique, allows an in depth analysis of the gastric mucosa. In a first study, Ji et al. [5] identified H. pylori gastritis with a 92% accuracy. The mean kappa value for inter-observer agreement was 0.78. In a second study, the same group focused on the severity of H. pylori-associated gastritis, especially atrophy and IM, with a rather good diagnostic accuracy [6]. HistologyThe ever well-known OLGA (Operative Link on Gastritis Assessment) staging system was highlighted again under the aspect of histology reporting of gastritis. It is especially valuable as it allows a prediction of the gastric cancer risk [7]. A long-term follow-up (12 years) of 93 patients confirmed that all invasive or intra-epithelial gastric neoplasia were consistently associated with high-risk (III ⁄ IV) OLGA stages [8].Immunohistochemistry can be used to assess the presence of H. pylori with more certainty. However, its systematic use in the routine of a pathology laboratory does not seem necessary because it is of no value in cases with an absence of pathological abnormality nor reactive gastropathy [6]. However, it allows the AbstractWhen an endoscopy is performed, it now becomes easier to observe indirect evidence of the presence of a Helicobacter pylori infection, given the progress of new methods including magnifying narrow band imaging or confocal l...

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Comparison of the Diagnostic Values of the 3 Different Stool Antigen Tests for the Noninvasive Diagnosis of Helicobacter pylori Infection

Cited by 26 publications

References 26 publications

Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection

Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection

A Novel Line Immunoassay Based on Recombinant Virulence Factors Enables Highly Specific and Sensitive Serologic Diagnosis of Helicobacter pylori Infection

Diagnosis of Helicobacter pylori Infection

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