Quantitative Correlation of Helicobacter pylori Stool Antigen (HpSA) Test with the Severity of H. pylori-Related Gastritis

Abstract

The Helicobacter pylori (H. pylori) load in both stomach and stool and the resulting severity of gastritis are important criteria in validating the status of H. pylori infection. We aimed to assess the reliability of the H. pylori stool antigen (HpSA) test for the primary diagnosis of H. pylori infection by calculating the best cut-off value to obtain the highest sensitivity and specificity in dyspeptic patients. We also investigated the correlation of HpSA test with the severity of gastritis and H. pylori load. The H. pylori statuses of 95 patients were evaluated by the positivity of both rapid urease test and microscopic detection of H. pylori in biopsy specimens, 88 subjects of whom were H. pylori positive. The sensitivity and specificity of the HpSA test were 51.1% (45/88) and 100% (7/7), respectively, according to the manufacturer's recommended cut-off value of 0.16. However, with the best cut-off value of 0.048, calculated by receiver operator characteristics analysis, the sensitivity of the test increased to 92.0% (81/88) with the same specificity. High values of the HpSA test were correlated with high scores of corpus H. pylori load and the severity of antrum and corpus inflammation ( p < 0.05). With the best cut-off value of the HpSA test, the primary diagnosis of H. pylori infection can be made with higher sensitivity and specificity. The HpSA test is a helpful tool that evaluates the severity of H. pylori infection and the degree of gastric inflammatory activity and gastric H. pylori load.

The impact of H. pylori and/or T. gondii infection on recurrence of gastritis and gastric ulcer

“…The remaining mild gastritis cases (69.2%) suffered from a single infection by either H. pylori or T. gondii. In consensus, it was reported that H. pylori antigen in stools was positive in 79/86 of antral or corpus gastritis cases, 19/21 of duodenitis cases, 2/2 of gastric ulcer cases, 8/8 of duodenal ulcer cases, 1/1 of gastric and duodenal ulcer cases and 17/21 of esophagitis cases [23] . It appears that our report is the first record of the effect of toxoplasmosis on gastritis severity in humans.…”

Diagnosis of Helicobacter pylori

“…A study from Turkey [45] investigated the quantitative correlation between the Premier Platinum HpSA and the severity of H. pylori ‐associated gastritis. After adjustment of the cut‐off level, the assay had a sensitivity and specificity of 92% and 100%, respectively.…”

Role of Sulforaphane in Protection of Gastrointestinal Tract Against H. pylori and NSAID-Induced Oxidative Stress

“…All participants were required to attend the hospital for collection of blood and stool samples at 0, 4, 8, and 16 weeks (eight weeks after the completion of the intervention); the dates corresponded to study days 0, 28, 56, and 112, respectively. Stool samples were analyzed for H. pylori stool antigen (HpSA) using an HpSA-ELISA kit from Meridian Bioscience, Inc., as previously described [ 29 ]. Serum pepsinogens I and II (PGI and PGII) were measured in blood samples collected from volunteers at these same time points, and the PGI/PGII ratio was computed [ 30 , 31 ].…”