1. Efficacy of noninvasive tests in the diagnosis of Helicobacter pylori infection in pediatric patients.
- Author
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Sabbi T, De Angelis P, Colistro F, Dall'Oglio L, di Abriola GF, and Castro M
- Subjects
- Adolescent, Antigens, Bacterial analysis, Bacterial Proteins blood, Biopsy, Child, Child, Preschool, Endoscopy, Digestive System, Feces microbiology, Female, Gastritis pathology, Helicobacter Infections immunology, Humans, Hyperemia pathology, Immunoenzyme Techniques, Immunoglobulin G analysis, Male, Predictive Value of Tests, Prospective Studies, Pyloric Antrum pathology, Saliva immunology, Sensitivity and Specificity, Urease, Helicobacter Infections diagnosis, Helicobacter pylori isolation & purification
- Abstract
Background: Helicobacter pylori infection is likely acquired in childhood. Helicobacter pylori is recognized as a cause of gastritis and peptic ulcer., Objective: To investigate some noninvasive tests, particularly H pylori fecal antigen, for the diagnosis of H pylori infection in comparison with the gold-standard invasive test, esophagogastroduodenoscopy with biopsy., Methods: We studied 250 patients (102 male; age range, 3-18 years) who underwent esophagogastroduodenoscopy with biopsy (histologic examination and rapid urease test) for a suspicious upper gastrointestinal disease; in all of them, fecal H pylori antigen, serum H pylori immunoglobulin G, and cytotoxin-associated gene product A immunoglobulin G were measured. Sensitivity and specificity of noninvasive tests were compared with those of the gold-standard esophagogastroduodenoscopy with biopsy., Results: Ninety-three patients (37%) had positive histopathologic (Giemsa staining) and rapid urease test results. The H pylori fecal antigen revealed a sensitivity of 97%, a specificity of 98%, a positive predictive value of 97%, and a negative predictive value of 98%; serum H pylori immunoglobulin G had a sensitivity of 86%, a specificity of 80%, a positive predictive value of 72%, and a negative predictive value of 90%; and serum cytotoxin-associated gene product A immunoglobulin G had a sensitivity of 83%, a specificity of 80%, a positive predictive value of 71%, and a negative predictive value of 89%., Conclusions: Our study demonstrates that among noninvasive and easily applicable tests, particularly in small children, H pylori fecal test is simple, suitable, and has high accuracy for the screening of H pylori-positive patients.
- Published
- 2005
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