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Characteristics of Helicobacter pylori-seropositive subjects according to the stool antigen test findings: a prospective study

  • Moon, Hee-Won (Department of Laboratory Medicine, Konkuk University School of Medicine) ;
  • Lee, Sun-Young (Department of Internal Medicine, Konkuk University School of Medicine) ;
  • Hur, Mina (Department of Laboratory Medicine, Konkuk University School of Medicine) ;
  • Yun, Yeo-Min (Department of Laboratory Medicine, Konkuk University School of Medicine)
  • Received : 2016.11.10
  • Accepted : 2017.02.11
  • Published : 2018.09.01

Abstract

Background/Aims: In countries with a higher risk of gastric atrophic gastritis, noninvasive tests are helpful for a more reliable diagnosis of Helicobacter pylori infection. The aim of this study was to evaluate the characteristics of seropositive subjects according to their stool H. pylori antigen test, serum pepsinogen (PG) assay, and endoscopic findings. Methods: Consecutive subjects who visited Konkuk University Medical Center for upper gastrointestinal endoscopy for a regular check-up were included in a prospective setting if the serum anti-H. pylori immunoglobulin G assay was positive. A H. pylori antigen stool test was measured using a stool H. pylori antigen enzyme-linked immunosorbent assay kit on the same day as a serum PG assay and endoscopy. Results: Of 318 seropositive subjects, 256 (80.5%) showed positive stool test findings. Subjects with a negative stool test result showed lower serum PG I (p < 0.001) and PG II (p < 0.001) levels and higher PG I/II ratio (p < 0.001) than those with a positive stool test. Chronic atrophic gastritis was more common in the positive stool test group than the negative stool test group on endoscopic finding (p = 0.009). A higher serum PG I level (p = 0.001) and a lower serum PG I/II ratio (p = 0.001) were independent risk factors for the presence of H. pylori antigen in stool. Conclusions: A high serum PG level denotes an ongoing current H. pylori infection with positive stool H. pylori antigen test findings. Seropositive subjects with increased gastric secreting ability tend to have H. pylori in their fecal material as reflected by a positive stool H. pylori antigen test finding.

Keywords

Acknowledgement

Supported by : Korean National Research Foundation

References

  1. Kokkola A, Rautelin H, Puolakkainen P, et al. Diagnosis of Helicobacter pylori infection in patients with atrophic gastritis: comparison of histology, 13C-urea breath test, and serology. Scand J Gastroenterol 2000;35:138-141. https://doi.org/10.1080/003655200750024290
  2. Talebkhan Y, Mohammadi M, Rakhshani N, et al. Interobserver variations in histopathological assessment of gastric pathology. Pathology 2009;41:428-432. https://doi.org/10.1080/00313020903041044
  3. 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;18:384-391. https://doi.org/10.1111/hel.12053
  4. Dominguez J, Forne M, Blanco S, et al. Comparison of a monoclonal with a polyclonal antibody-based enzyme immunoassay stool test in diagnosing Helicobacter pylori infection before and after eradication therapy. Aliment Pharmacol Ther 2006;23:1735-1740. https://doi.org/10.1111/j.1365-2036.2006.02936.x
  5. Shimoyama T, Oyama T, Matsuzaka M, Danjo K, Nakaji S, Fukuda S. Comparison of a stool antigen test and serology for the diagnosis of Helicobacter pylori infection in mass survey. Helicobacter 2009;14:87-90. https://doi.org/10.1111/j.1523-5378.2009.00672.x
  6. Choi J, Kim CH, Kim D, et al. Prospective evaluation of a new stool antigen test for the detection of Helicobacter pylori, in comparison with histology, rapid urease test, (13) C-urea breath test, and serology. J Gastroenterol Hepatol 2011;26:1053-1059. https://doi.org/10.1111/j.1440-1746.2011.06705.x
  7. Matsuda M, Noda Y, Takemori Y. Utility and limitations of a method for detecting Helicobacter pylori-specific antigens in the stool. J Gastroenterol 2003;38:222-228. https://doi.org/10.1007/s005350300040
  8. Lin HJ, Lo WC, Perng CL, et al. Helicobacter pylori stool antigen test in patients with bleeding peptic ulcers. Helicobacter 2004;9:663-668. https://doi.org/10.1111/j.1083-4389.2004.00276.x
  9. Manes G, Balzano A, Iaquinto G, et al. Accuracy of the stool antigen test in the diagnosis of Helicobacter pylori infection before treatment and in patients on omeprazole therapy. Aliment Pharmacol Ther 2001;15:73-79. https://doi.org/10.1046/j.1365-2036.2001.00907.x
  10. Miki K, Fujishiro M, Kodashima S, Yahagi N. Longterm results of gastric cancer screening using the serum pepsinogen test method among an asymptomatic middle-aged Japanese population. Dig Endosc 2009;21:78-81. https://doi.org/10.1111/j.1443-1661.2009.00839.x
  11. Nardone G, Rocco A, Staibano S, et al. Diagnostic accuracy of the serum profile of gastric mucosa in relation to histological and morphometric diagnosis of atrophy. Aliment Pharmacol Ther 2005;22:1139-1146. https://doi.org/10.1111/j.1365-2036.2005.02734.x
  12. Lee SP, Lee SY, Kim JH, et al. Correlation between Helicobacter pylori infection, IgE hypersensitivity, and allergic disease in Korean adults. Helicobacter 2015;20:49-55. https://doi.org/10.1111/hel.12173
  13. Choi HS, Lee SY, Kim JH, et al. Combining the serum pepsinogen level and Helicobacter pylori antibody test for predicting the histology of gastric neoplasm. J Dig Dis 2014;15:293-298. https://doi.org/10.1111/1751-2980.12144
  14. Gritti I, Banfi G, Roi GS. Pepsinogens: physiology, pharmacology pathophysiology and exercise. Pharmacol Res 2000;41:265-281. https://doi.org/10.1006/phrs.1999.0586
  15. Lee SY. Endoscopic gastritis, serum pepsinogen assay, and Helicobacter pylori infection. Korean J Intern Med 2016;31:835-844. https://doi.org/10.3904/kjim.2016.166
  16. Lee SY, Moon HW, Hur M, Yun YM. Validation of western Helicobacter pylori IgG antibody assays in Korean adults. J Med Microbiol 2015;64:513-518. https://doi.org/10.1099/jmm.0.000050
  17. Lee SY. Current progress toward eradicating Helicobacter pylori in East Asian countries: differences in the 2013 revised guidelines between China, Japan, and South Korea. World J Gastroenterol 2014;20:1493-1502. https://doi.org/10.3748/wjg.v20.i6.1493
  18. Tatemichi M, Sasazuki S, Inoue M, Tsugane S; JPHC Study Group. Clinical significance of IgG antibody titer against Helicobacter pylori. Helicobacter 2009;14:231-236. https://doi.org/10.1111/j.1523-5378.2009.00681.x
  19. De Schryver A, Van Winckel M, Cornelis K, Moens G, Devlies G, De Backer G. Helicobacter pylori infection: further evidence for the role of feco-oral transmission. Helicobacter 2006;11:523-528. https://doi.org/10.1111/j.1523-5378.2006.00454.x
  20. He CY, Sun LP, Gong YH, Xu Q, Dong NN, Yuan Y. Serum pepsinogen II: a neglected but useful biomarker to differentiate between diseased and normal stomachs. J Gastroenterol Hepatol 2011;26:1039-1046. https://doi.org/10.1111/j.1440-1746.2011.06692.x
  21. Kumar S, Kumari N, Mittal RD, Ghoshal UC. Pepsinogen-II 100 bp ins/del gene polymorphism and its elevated circulating levels are associated with gastric cancer, particularly with Helicobacter pylori infection and intestinal metaplasia. Gastric Cancer 2016;19:808-816. https://doi.org/10.1007/s10120-015-0550-8
  22. Lahner E, Vaira D, Figura N, et al. Role of noninvasive tests (C-urea breath test and stool antigen test) as additional tools in diagnosis of Helicobacter pylori infection in patients with atrophic body gastritis. Helicobacter 2004;9:436-442. https://doi.org/10.1111/j.1083-4389.2004.00262.x
  23. Tu H, Sun L, Dong X, et al. Serum anti-Helicobacter pylori immunoglobulin G titer correlates with grade of histological gastritis, mucosal bacterial density, and levels of serum biomarkers. Scand J Gastroenterol 2014;49:259-266. https://doi.org/10.3109/00365521.2013.869352
  24. Hayashi S, Imamura J, Kimura K, Saeki S, Hishima T. Endoscopic features of lymphoid follicles in Helicobacter pylori-associated chronic gastritis. Dig Endosc 2015;27:53-60. https://doi.org/10.1111/den.12335
  25. Dore MP, Negrini R, Tadeu V, et al. Novel monoclonal antibody-based Helicobacter pylori stool antigen test. Helicobacter 2004;9:228-232. https://doi.org/10.1111/j.1083-4389.2004.00228.x
  26. Yee YK, Yip KT, Que TL, et al. Efficacy of enzyme immunoassay for the detection of Helicobacter pylori antigens in frozen stool specimens: local validation. Aliment Pharmacol Ther 2002;16:1739-1742. https://doi.org/10.1046/j.1365-2036.2002.01338.x

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