COMPARISON OF VARIOUS HELICOBACTER-PYLORI DETECTION METHODS - SEROLOGY, HISTOLOGY AND BACTERIOLOGY

The current gold standard test for diagnosis of Helicobacter pylori in volves histological staining and/or urease testing of antral biopsy sp ecimens. However, these methods are invasive, and alternative non-inva sive methods, i.e. the urease breath test and serological tests, are a vailable. The test for H. pylori-specific serum immunoglobulin G (IgG) is now available commercially. The aim of this study was to compare t he gold standard tests for diagnosis of H. pylori to the non-invasive method of detecting IgG antibody in the serum. Two hundred and twenty- five (225) subjects were tested for H. pylori by histological staining , urease testing, direct microscopy of antral biopsy specimens and qua ntification of serum IgG antibody. The population examined was divided into 2 groups - a group of 52 patients with no gastrointestinal sympt oms and a group of 173 patients with dyspepsia. Out of 173 dyspeptic p atients, 22 (12.7%) were false-positive to H. pylori. Out of 52 non-dy speptic subjects, 30 (57.7%) were false-positive (p<0.0001). The sensi tivity and specificity were 91.6% and 51.7%, respectively. The specifi city and positive predictive value increased by approximately 30% when the subjects examined were in the younger age group (<30 years), whil e the sensitivity and the negative predictive value did not change sig nificantly. This study indicates that serological testing is not recom mended for diagnosis nor is it recommended for follow-up treatment, es pecially among the other age group (>30 years).