Helicobacter pylori stool antigen test: evaluation of diagnostic accuracy in Egyptian patients with dyspepsia

ABSTRACT

Thirty-six H. pylori infected patients [proved by positive Grams stained film, rapid urease test, culture and histopathology] as well as ten non-infected patients selected among 120 Egyptian patients presenting with dyspepsia were included in the present study. There was no statistically significant difference between H. pylori positive and negative patients concerning their presenting symptoms. The endoscopic examination revealed that gastritis was more prevalent in H. pylori infected patients. A significant relation was found between the complaint of regurgitation and the endoscopic finding of hiatus hernia as well as between the complaints of heart burn and epigastric pain on one hand and the endoscopic detection of gastritis on the other hand. The histopathological examination of gastric biopsies revealed that gastritis in its moderate degree was more prevalent in H. pylori infected patients than in the controls. Stool specimens collected from 36 H. pylori positive patients and 10 ten non-infected controls were examined by an enzyme immunoassay for the detection of H. pylori antigens [Premier Platinum HpSA]. The HpSA test was positive in 35 out of the 36 H. pylori infected patients and in 2 out of the 10 non-infected cases. The sensitivity and specificity of the test were 97.2% and 80%, respectively. The overall accuracy rate was 93.5%. The positive and negative predictive values for HpSA test were 94.6% and 89%, respectively