Volume 2008, Issue 2
  • ISSN: 0253-8253
  • E-ISSN: 2227-0426


To evaluate invasive (biopsy related) tests and noninvasive (serological) tests in the diagnosis of H.pylori, ninety-two adults (54 male, 38 female) presenting with dyspepsia were studied after classification into two groups on the basis of endoscopical diagnosis; 46 patients with erosive diseases (gastroduodenal ulcers or gastroduodenal erosions) and 46patients with non-erosive diseases (gastritis or gastroduodenitis). Sera were testedfor anti-H.pylori IgG and IgM by an immunochromatography card test and ELISA respectively. Three antral biopsies were taken for biopsy urease test (BUT), bacterial culture and histological examination. Stool samples were obtained from only 30 dyspeptic cases for H.pylori antigen detection (HpSA) by an ELISA method.

H. pylori was detected in 81 of 92 cases; these were positive by one or more of the gold standard tests (culture, histology and biopsy-urease test). Histological examination yielded the highest frequency of microorganism detection (71.7%), followed by BUT (68.5%) and then bacterial culture (26.1%). In erosive disorders the BUT gave the highest frequency ofpositivity (78.3%),followed by histological examination (67.4%), and then bacterial culture (41.3%) but in non-erosive disorders histological examination gave the highest positive results (76.1%) followed by BUT (58.7%) and bacterial culture (10.9%). The overall sensitivities of BUT, histology and bacterial culture of H.pylori were 77.8%, 81.5% and 29.6% respectively. Serologically the anti-H.pylori IgG test yielded the highest frequency of positive results (80.4%), followed by HpSA test (66.7%) and the least positive was anti-H.pylori IgM test (65.2%). In the light of the gold standard tests used (biopsy-related tests), the validity of anti-H.pylori IgG test, anti-H.pylori IgM test and HpSA test were determined; the sensitivities being 79%, 65.4% and 75% respectively and their specificities were 9.1%, 36.4% and 66.7% respectively. The positive and negative predictive values, the positive and negative likelihood ratios of serological tests were also evaluated.

Conclusion: The most sensitive invasive test (biopsy related) and noninvasive (serological) tests were histological examination and IgG immunochromatography card tests respectively.


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  • Article Type: Research Article
Keyword(s): ELISA Immunochromatography , Endoscopy and Helicobacter pylori
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