Research Article
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Retrospective Evaluation of Patients with Positive Helicobacter pylori Antigen Test in Stool Samples Together with Pathology Findings

Year 2023, Volume: 1 Issue: 2, 26 - 29, 22.06.2023

Sibel Gülseroğlu Nisel Yılmaz Duygu Tekin Birsen Gizem Özamrak Esra Canan Kelten Talu

Abstract

Aim: Helicobacter pylori (H. pylori) is a bacterium associated with gastric adenocarcinoma and MALT lymphoma, which causes peptic and chronic ulcer disease in the gastric mucosa in humans. There are non invasive and invasive tests for the diagnosis of H. pylori infection. Among these tests, endoscopic biopsy is the gold standard. In our study, we aimed to compare the specificity and sensitivity of stool
antigen test used for the diagnosis of H. pylori with gastric endoscopic biopsy.

Material and Method: A total of 2270 patients who applied to Health Sciences University Tepecik Training and Research Hospital from various polyclinics among May 2021 and May 2022 with dyspeptic complaints and requested stool antigen test were screened retrospectively. 222 patients who underwent simultaneous stool antigen and endoscopic biopsy for the diagnosis of H. pylori were included in the
study.

Results: While endoscopic biopsy was positive in 46 (70.8%) of 65 patients with positive H. pylori antigen test in stool; H. pylori was positive in endoscopic biopsy in 36 (23%) of 157 patients with negative H. pylori antigen test in stool. Compared with endoscopic biopsy, fecal H. pylori antigen test had a sensitivity of 70.6%, a specificity of 77.1%, a positive predictive value of 70.3%, and a negative predictive value of
77.1%.

Conclusion: When the patients with positive H. pylori antigen test in their stool samples are evaluated together with the pathology findings, the sensitivity and specificity values of the stool antigen diagnostic test are lower than the biopsy.

References

  • 1. Lawson AJ. Helicobacter. In: Jorgensen JH, Landry ML, Warnock DW (ed). Manual of Clinical Microbiology. 10. ed. Washington DC: ASM Press. 2011;900-915.
  • 2. Tekin F, Günşar F, Karasu Z, et al. Analysis of frequency of duodenal and gastric ulcer patients and frequency of Helicobacter pylori in these cases according to each year: A 10- year retrospective analysis. Akademik Gastroentroloji Dergisi. 2008;7(1):30-33.
  • 3. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter infection-the Maastricht V/Florence Consensus Report. Gut. 2017;66:6-30.
  • 4. Zagari RM, Romiti A, Ierardi E, et al. The “three-in-one” formulation of bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotics supplementation: Efficacy and safety in daily clinical practice. Helicobacter. 2018;23:59-65.
  • 5. Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the ¹³C-Urea breath test. BMC Public Health. 2013;13:1215-1227.
  • 6. Us D, Hasçelik G. Seroprevalence of Helicobacter pylori infection in an Asymptomatic Turkish population. J Infect. 1998;37(2):148-150.
  • 7. Özkan TB. Çocuklarda H. pylori enfeksiyonunda seroloji, tanı ve tedavi. Uludağ Üni Tıp Fak Derg. 2007;33(2):81-85.
  • 8. Muhsen KH, Athamna A, Athamna M, Spungin-Bialik A, Cohen D. Prevalence and risk factors of Helicobacter pylori infection among healthy 3- to 5- year old Israeli Arab children. Epidemiol nfect. 2006;134(5):990-996.
  • 9. Açık Y, Gülbayrak C, Dönder E, Yalnız M. Fırat Tıp merkezine dispeptik yakınmalarla başvuran hastalarda Helicobacter pylori sıklığı ve etkileyen faktörler. OMÜ Tıp Fak Derg. 2003;20(2):82-88.
  • 10. Bulut M, Armağan E, Kıyıcı M, Balcı V, Atar N, Gürel S. Acil servise epigastrik ağrı yakınmasıyla başvuran hastalarda Helicobacter pylori sıklığı ve tanıda kalitatif serum IgG testinin yeri. Uludağ Üni Tıp Fak Derg. 2004;30(1):7-10.
  • 11. Malfertheiner P, Megraud F, O’Morain C, et al. The European Helicobacter Study Group. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus report. Gut. 2007;56(6):772-781.
  • 12. Wu IC, Wang SW, Yang YC, et al. Comparison of a new office based stool immunoassay and 13C-UBT in the diagnosis of current Helicobacter pylori infection. J Lab Clin Med. 2006;147(3):145- 149.
  • 13. Zambon CF, Basso D, Navaglia F, et al. Non-invasive diagnosis of Helicobacter pylori infection: simplified 13Curea breath test, stool antigen testing, or DNA PCR in human feces in a clinical laboratory setting. Clin Biochem. 2004;37(4):261-267.
  • 14. Zhang M, Zhou YZ, Li XY, et al. Seroepidemiology of Helicobacter pylori infection in elderly people in the Beijing region, China, World Journal of Gastroenterology. 2014;20(3):635–639.
  • 15. Chen HL, Chen MJ, Shih SC, Wang HY, Lin IT, Bair MJ. Socioeconomic status, personal habits, and prevalence of Helicobacter pylori infection in the inhabitants of Lanyu, Journal of the Formosan Medical Association. 2014;113:278–283.
  • 16. Rugge M, Capelle LG, Cappellesso R, Nitti D, Kuipers EJ. Precancerous lesions in the stomach: from biology to clinical patient management. Best Pract Res Clin Gastroenterol. 2013;27:205- 223.
  • 17. Leal YA, Roberto CR, Abraham SJ, Juan RV, Laura LF, Javier T. Utility of stool sample-based tests for the diagnosis of Helicobacter pylori infection in children. J Pediatr Gastroentereol Nutr. 2011;52(6):718-28. https://doi.org/10.1097/MPG.0b013e3182077d33 18. Opekun AR, Zierold C, Rode A, et al. Clinical performance of the automated LIAISON® Meridian H. pylori SA Stool Antigen Test. BioMed research international. 2020.
  • 19. Korkmaz H, Kesli R, Karabagli P, Terzi Y. Comparison of the diagnostic accuracy of five different stool antigen tests for the diagnosis of Helicobacter pylori infection. Helicobacter. 2013;18(5):384– 391.
  • 20. Kato M, Ota H, Okuda M, et al. Guidelines for the management of Helicobacter pylori infection in Japan. Helicobacter. 2019;24 (4).
  • 21. Lario S, Ramírez-Lázaro MJ, Montserrat A, et al. Diagnostic accuracy of three monoclonal stool tests in a large series of untreated Helicobacter pylori infectedpatients. ClinBiochem.2016;49(9):682–687.
  • 22. Khoder G, Muhammad JS, Mahmoud I, Soliman SSM, Burucoa C. Prevalence of Helicobacter pylori and Its Associated Factors among Healthy Asymptomatic Residents in the United Arab Emirates. Pathogens. 2019 Apr 1;8(2):44. doi: 10.3390/pathogens8020044
  • 23. Simon CG, Andres FCA, Tomas CG, et.al. Prevalence of Helicobacter pylori and Histopathological Features in Gastric Biopsies from Patients with Dyspeptic Symptoms at a Referral Center in Medellin. Rev Col Gastroenterol. 2016;31(1).
  • 24. Hooi JKY, Lai WY, Ng WK, et al. Global prevalance of Helicobacter pylori infection: Systematic review and meta analysis. Gastroenterology. 2017;153(2):420-429.
  • 25. Bor S, Kitapcıoglu G, Kasap E. Prevalance of gastroesophageal reflux disease in a country which a high occurance of Helicobacter pylori. World J Gastroenterol. 2017;23(3):525-532.
  • 26. Keşli R, Bilgin H, Ünlü Y, Güngör G. Evaluation of diagnostic performance of culture, rapid urease test and histopathology in the diagnosis of Helicobacter pylori infection, and in vitro activity of various antimicrobials against Helicobacter pylori. Klimik Derg. 2022;35(1):36-9.
  • 27. Konakcı N, Gülten M, İbanoğlu MS, et al. Kronik aktif gastritli olgularda Helicobacter pylori sıklığı. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2010;36(1):7-10.
  • 28. Uyanıkoğlu A, Coşkun M, Binici D, ve ark. Frequency of Helicobacter pylori in patients underwent endoscopy. Dicle Medical Journal. 2012;39(2):197-200.
  • 29. Vural D, Karacan G, Tanrıverdi Y, Bilgin K, Birinci A. Helicobacter pylori Enfeksiyonu Tanısında Gaitada Antijen Arama Test Sonuçlarının Değerlendirilmesi. Sağlık Bilimlerinde Değer.2022;12(2):246-249.
  • 30. Alzoubi H, Al-Mnayyis A, Alrfoa İ, et al. The Use of13C-Urea Breath Test for Non-Invasive Diagnosis of Helicobacter pylori Infection in Comparison to Endoscopy and Stool Antigen Test. Diagnostics. 2020;10(7):448.
  • 31. Iranikhah A, Ghadir MR, Sarkeshikian S, et al. Stool Antigen Tests for the Detection of Helicobacter pylori in Children. Iranian Journal of Pediatrics. 2013;138-142.

Dışkı Örneklerinde Helicobacter pylori Antijen Testi Pozitifliği olan Hastaların Patoloji Bulguları ile Beraber Retrospektif Olarak Değerlendirilmesi

Year 2023, Volume: 1 Issue: 2, 26 - 29, 22.06.2023

Sibel Gülseroğlu Nisel Yılmaz Duygu Tekin Birsen Gizem Özamrak Esra Canan Kelten Talu

Abstract

Amaç: Helicobacter pylori (H. pylori), insan gastrik mukozasında peptik ve kronik ülser hastalığına sebep olan mide adenokarsinomu ve MALT lenfoma ile ilişkili bir bakteridir. H. pylori enfeksiyonun tanısı için invaziv olan ve olmayan testler bulunmaktadır. Yapılan testler arasında endoskopik biyopsi altın standarttır. Çalışmamızda H. pylori tanısı için kullanılan dışkı antijen testinin özgüllük ve duyarlılığının mide endoskopik biyopsisiyle karşılaştırılması amaçlanmıştır.

Gereç ve Yöntem: Sağlık Bilimleri Üniversitesi Tepecik Eğitim ve Araştırma Hastanesi’ne Mayıs 2021- Mayıs 2022 tarihleri arasında çeşitli polikliniklerden gelen dispeptik şikayetler ile başvuran ve dışkı antijen testi istenen toplam 2270 hasta retrospektif olarak taranmıştır. H. pylori tanısı için eşzamanlı dışkıda antijen testi ve endoskopik biyopsi uygulanan 222 hasta çalışmaya dâhil edilmiştir.

Bulgular: Dışkıda H. pylori antijen testi pozitif saptanan 65 hastanın 46 (%70,8)’sında endoskopik biyopsi pozitif iken, dışkıda H. pylori antijen testi negatif saptanan 157 hastanın 36 (%23)’sında endoskopik biyopsi sonucu H. pylori pozitif olarak değerlendirilmiştir. Endoskopik biyopsi ile dışkıda H. pylori antijen testinin karşılaştırılmasında duyarlılık %70,6, özgüllük %77,1, pozitif prediktif değer %70,3, negatif prediktif değer %77,1 olarak bulunmuştur.

Sonuç: Dışkı örneklerinde H. pylori antijen testi pozitifliği olan hastaların patoloji bulguları ile birlikte retrospektif olarak değerlendirilmesinde dışkıda antijen tanı testinin duyarlılık ve özgüllük değerleri biyopsiye oranla düşük görülmektedir.

Keywords

dışkı antijen testi dispepsi endoskopi helicobacter pylori

References

  • 1. Lawson AJ. Helicobacter. In: Jorgensen JH, Landry ML, Warnock DW (ed). Manual of Clinical Microbiology. 10. ed. Washington DC: ASM Press. 2011;900-915.
  • 2. Tekin F, Günşar F, Karasu Z, et al. Analysis of frequency of duodenal and gastric ulcer patients and frequency of Helicobacter pylori in these cases according to each year: A 10- year retrospective analysis. Akademik Gastroentroloji Dergisi. 2008;7(1):30-33.
  • 3. Malfertheiner P, Megraud F, O’Morain CA, et al. Management of Helicobacter infection-the Maastricht V/Florence Consensus Report. Gut. 2017;66:6-30.
  • 4. Zagari RM, Romiti A, Ierardi E, et al. The “three-in-one” formulation of bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotics supplementation: Efficacy and safety in daily clinical practice. Helicobacter. 2018;23:59-65.
  • 5. Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the ¹³C-Urea breath test. BMC Public Health. 2013;13:1215-1227.
  • 6. Us D, Hasçelik G. Seroprevalence of Helicobacter pylori infection in an Asymptomatic Turkish population. J Infect. 1998;37(2):148-150.
  • 7. Özkan TB. Çocuklarda H. pylori enfeksiyonunda seroloji, tanı ve tedavi. Uludağ Üni Tıp Fak Derg. 2007;33(2):81-85.
  • 8. Muhsen KH, Athamna A, Athamna M, Spungin-Bialik A, Cohen D. Prevalence and risk factors of Helicobacter pylori infection among healthy 3- to 5- year old Israeli Arab children. Epidemiol nfect. 2006;134(5):990-996.
  • 9. Açık Y, Gülbayrak C, Dönder E, Yalnız M. Fırat Tıp merkezine dispeptik yakınmalarla başvuran hastalarda Helicobacter pylori sıklığı ve etkileyen faktörler. OMÜ Tıp Fak Derg. 2003;20(2):82-88.
  • 10. Bulut M, Armağan E, Kıyıcı M, Balcı V, Atar N, Gürel S. Acil servise epigastrik ağrı yakınmasıyla başvuran hastalarda Helicobacter pylori sıklığı ve tanıda kalitatif serum IgG testinin yeri. Uludağ Üni Tıp Fak Derg. 2004;30(1):7-10.
  • 11. Malfertheiner P, Megraud F, O’Morain C, et al. The European Helicobacter Study Group. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus report. Gut. 2007;56(6):772-781.
  • 12. Wu IC, Wang SW, Yang YC, et al. Comparison of a new office based stool immunoassay and 13C-UBT in the diagnosis of current Helicobacter pylori infection. J Lab Clin Med. 2006;147(3):145- 149.
  • 13. Zambon CF, Basso D, Navaglia F, et al. Non-invasive diagnosis of Helicobacter pylori infection: simplified 13Curea breath test, stool antigen testing, or DNA PCR in human feces in a clinical laboratory setting. Clin Biochem. 2004;37(4):261-267.
  • 14. Zhang M, Zhou YZ, Li XY, et al. Seroepidemiology of Helicobacter pylori infection in elderly people in the Beijing region, China, World Journal of Gastroenterology. 2014;20(3):635–639.
  • 15. Chen HL, Chen MJ, Shih SC, Wang HY, Lin IT, Bair MJ. Socioeconomic status, personal habits, and prevalence of Helicobacter pylori infection in the inhabitants of Lanyu, Journal of the Formosan Medical Association. 2014;113:278–283.
  • 16. Rugge M, Capelle LG, Cappellesso R, Nitti D, Kuipers EJ. Precancerous lesions in the stomach: from biology to clinical patient management. Best Pract Res Clin Gastroenterol. 2013;27:205- 223.
  • 17. Leal YA, Roberto CR, Abraham SJ, Juan RV, Laura LF, Javier T. Utility of stool sample-based tests for the diagnosis of Helicobacter pylori infection in children. J Pediatr Gastroentereol Nutr. 2011;52(6):718-28. https://doi.org/10.1097/MPG.0b013e3182077d33 18. Opekun AR, Zierold C, Rode A, et al. Clinical performance of the automated LIAISON® Meridian H. pylori SA Stool Antigen Test. BioMed research international. 2020.
  • 19. Korkmaz H, Kesli R, Karabagli P, Terzi Y. Comparison of the diagnostic accuracy of five different stool antigen tests for the diagnosis of Helicobacter pylori infection. Helicobacter. 2013;18(5):384– 391.
  • 20. Kato M, Ota H, Okuda M, et al. Guidelines for the management of Helicobacter pylori infection in Japan. Helicobacter. 2019;24 (4).
  • 21. Lario S, Ramírez-Lázaro MJ, Montserrat A, et al. Diagnostic accuracy of three monoclonal stool tests in a large series of untreated Helicobacter pylori infectedpatients. ClinBiochem.2016;49(9):682–687.
  • 22. Khoder G, Muhammad JS, Mahmoud I, Soliman SSM, Burucoa C. Prevalence of Helicobacter pylori and Its Associated Factors among Healthy Asymptomatic Residents in the United Arab Emirates. Pathogens. 2019 Apr 1;8(2):44. doi: 10.3390/pathogens8020044
  • 23. Simon CG, Andres FCA, Tomas CG, et.al. Prevalence of Helicobacter pylori and Histopathological Features in Gastric Biopsies from Patients with Dyspeptic Symptoms at a Referral Center in Medellin. Rev Col Gastroenterol. 2016;31(1).
  • 24. Hooi JKY, Lai WY, Ng WK, et al. Global prevalance of Helicobacter pylori infection: Systematic review and meta analysis. Gastroenterology. 2017;153(2):420-429.
  • 25. Bor S, Kitapcıoglu G, Kasap E. Prevalance of gastroesophageal reflux disease in a country which a high occurance of Helicobacter pylori. World J Gastroenterol. 2017;23(3):525-532.
  • 26. Keşli R, Bilgin H, Ünlü Y, Güngör G. Evaluation of diagnostic performance of culture, rapid urease test and histopathology in the diagnosis of Helicobacter pylori infection, and in vitro activity of various antimicrobials against Helicobacter pylori. Klimik Derg. 2022;35(1):36-9.
  • 27. Konakcı N, Gülten M, İbanoğlu MS, et al. Kronik aktif gastritli olgularda Helicobacter pylori sıklığı. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2010;36(1):7-10.
  • 28. Uyanıkoğlu A, Coşkun M, Binici D, ve ark. Frequency of Helicobacter pylori in patients underwent endoscopy. Dicle Medical Journal. 2012;39(2):197-200.
  • 29. Vural D, Karacan G, Tanrıverdi Y, Bilgin K, Birinci A. Helicobacter pylori Enfeksiyonu Tanısında Gaitada Antijen Arama Test Sonuçlarının Değerlendirilmesi. Sağlık Bilimlerinde Değer.2022;12(2):246-249.
  • 30. Alzoubi H, Al-Mnayyis A, Alrfoa İ, et al. The Use of13C-Urea Breath Test for Non-Invasive Diagnosis of Helicobacter pylori Infection in Comparison to Endoscopy and Stool Antigen Test. Diagnostics. 2020;10(7):448.
  • 31. Iranikhah A, Ghadir MR, Sarkeshikian S, et al. Stool Antigen Tests for the Detection of Helicobacter pylori in Children. Iranian Journal of Pediatrics. 2013;138-142.
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Medical Microbiology
Journal Section Research Article
Authors

Sibel Gülseroğlu 0000-0002-7125-074X

Nisel Yılmaz 0000-0001-7435-2461

Duygu Tekin 0000-0002-4913-622X

Birsen Gizem Özamrak 0000-0001-7299-0603

Esra Canan Kelten Talu 0000-0001-8767-4275

Early Pub Date June 22, 2023
Publication Date June 22, 2023
Submission Date March 14, 2023
Published in Issue Year 2023 Volume: 1 Issue: 2

Cite

AMA Gülseroğlu S, Yılmaz N, Tekin D, Özamrak BG, Kelten Talu EC. Dışkı Örneklerinde Helicobacter pylori Antijen Testi Pozitifliği olan Hastaların Patoloji Bulguları ile Beraber Retrospektif Olarak Değerlendirilmesi. Ağrı Med J. June 2023;1(2):26-29.
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