Diagnostic value of serologric test for detection of Helicobacter pylori infection

BACKGROUND: Ever since Helicobacter pylori was discovered in 1983 by Warren and Marshall, many studies were conducted resulting in drastic change of the previous concept of gastrointestinal disorders and its treatment. Most people in developing countries are considered to be exposed to the organism at a very early age, being more susceptible to infection. This study was done to find out the diagnostic value of serology antibody test for Helicobacter pylori infection by comparing differences in those checked positive for H. pylori relative to their symptoms and findings on endoscopy, biopsy, and barium swallow. METHODS: Subjects totaling 1240 who visited the Health Promotion Center of a university hospital were surveyed with questionnaire and were performed serology antibody test for H. pylori. 532 subjects underwent endoscopy and biopsy and in 708 subjects barium swallow was performed. All subjects were compared with respect to gastrointestinal symptoms, findings of pathology from the endoscopic and radiologic procedures with their antibody test results and titration. RESULTS: Among 1240 patients, 804 (64.8%) were positive for Helicobacter pylori antibody. There were 449 males (68%), and 355 females (61%), which was statistically significant (p< 0.05).There was no difference in the positive rates of H. pylori according to smoking, drinking, and exercise. Higher prevalence of family history for gastric cancer was shown among those positive for H. pylori (p< 0.01). There was no difference noted in relation to gastric symptoms or past history of gastrointestinal disorders in the two groups. Relative to the gastric symptoms complained by the patients, the findings on endoscopy, biopsy and radiologic study, most of those checked positive for H. pylori were shown to have antibody titers in the range of 20 to 40 units/mL with 83.1% for symptoms, 83.6% for endoscopy, 84.8% for biopsy, 81.7% for barium swallow. CONCLUSION: There was no significant difference among those positive and negative for serology antibody test with respect to gastrointestinal symptoms, findings on endoscopy, biopsy, and barium swallow in this study. But because H. pylori is associated with most of the gastrointestinal pathology, testing H. pylori with serology antibody method can be beneficial and useful for its accuracy in primary care setting where further investigation is not possible.

The Relationship of Helicobacter pylori Infection and Upper Gastrointestinal Diseases in Korean Adults

Helicobacter pylori infection is associated with various gastrointestinal disorders. It has been proved that those who are infected leads to gastritis in 100% and that there is no natural recovery. Therefore, treatment to cradicate the organism is essential to block the natural course of many disorders of the gastrointestinal tract, that may lead to gastric cancer which is the number one leading cause of death among cancer in Korea. The study was conducted in order to find out the prevalence of H. pylori infection in Inchon area and the relationship between H. pylori infection and its diverse pathology. The study involved 1,872 applicants screened for Helicobacter pylori infection by serology antibody test in the Health Promotion Center at Inha University Hospital in Inchon, Among them, 1,203(64.3%) were positive including 651 males(67.2%), and 524 females(61,0%). There was no significant statistical difference among age groups. In males of age group 40-49 years of age, and females of age group 50-59, H. pylori infection were most common. There were no differences among the H. pylori positive and negative group with respect to fatally history, past history, lob, lifestyle behavior (including smoking, drinking, and exercise), Epigastaic pain, diarrhea, rectal bleeding were more common and statistically different in H pylori positives compared to those of negatives. In the findings of upper gastrointestinal barium swallow, there were no differences between the two groups. H. pylori positive group showed more endoscopic findings compared to negative group, Out of the 1,239 total findings H pylori positive group showed 873 endoscopic findings as opposed to 366 in the negative group. Among the H pylori positive group, chronic superficial gastritis was most common with 338, followed by gastric crosion 134, duodenal ulcer 53. In the negative group, chronic superficial gastritis was also the most common with 160, followed by gastric crosion 79, and hiatal hernia 32 Gastric subepithelial hemorrhage(p<0.001), duodenal ulcer(p<0.022), intestinal metaplasia(p<0.024) were found to be significantly common in H pylori positive group compared to those of the negative group. Hiatal hernia(p<0.001) was found to be higher in the negative group. The sensitivity and specificity of CLO test performed during the endoscopy procedure were 79.9% and 100%, respectively. The sensitivity and specificity of endoscopic diopsy were 51.9% and 100%, respectively.