Comparative Study for the Accuracy of Helicobacter pylori Diagnostic Methods Associated with Some Inflammatory Factors
Keywords:Helicobacter pylori, Gastric ulcer, Invasive test, noninvasive test, immunological parameters
AbstractThis Study was intended to diagnose H. pyiori the major causative pathogen in gastro duodenal irritation and ulceration. Differert techniques were used invasive tests (histopathological examina-tion, rapid urea CLO test and culture) , while noninvasive tests includes (serological tests and stool antigen) in addition to determination of some immune response factors (IgM , IgG , IgA) as well as (IL – 8 and IFN – y) in Ptients Sera. According to the results of invasive diagnostic method 30/113 (26.69%) patients were considered to be infected and 83/113(73.31%) patients were considered as noninfeted was contrasted with noninvasive diagnostic method 25/113 (22.14%) patients were considered to be infected and 88/133(77.83%) patients were considered as noninfeted. In order to get the overall percentage of the infected people included in this study, we merge the results of the two methods ,so we found out that the total infected patients with H. pylori diagnosed by invasive and noninvasive methods were 42 /113 (37.2%) while the noninfected 71/113 (62.8) disseminated as 27/68(39.71%) infect-ed male ,which was privileged than the infected female when it was 15/45(33.33%). The high prevalence of H. pylori infection in the age group ranging between (46-60) in male and female. Histology (invasive teq.) and ECO rapid test (noninvasive teq.) were considered as the ‘‘best techniques ’’ for H. pylori detection, in the outlook of its high specificity, sensitivity and because it detected the major number of H. pylori-positive patients along with the other techniques used in this work. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for histology were 100,100,100 and 94.5% , respectively, while for the ECO rapid test they were 96, 93, 91.5, and 97.14%. Culture (invasive teq.) and IgG anti H. pylori (noninvasive teq.) coming secondly in the diagnosis of H. pylori infection because they detected a little fewer number of infected patients than the first two teq. as noted above. The sensitivity, specificity, (PPV) (NPV) for Culture were 80%, 97% ,96.96% and87.5% and for IgG anti H. pylori were 85%, 91%,92.8% and 97.8%. Finally the smallest patient number was obtained from the rest of all the six teq. were used in the present work obtained from the urea CLO test and stool antigen, in-vasive and noninvasive teq. respectively. The present research found out that there were a relationship between the results of rapid anti H. pylori ECO test, antibody titer in ELFA, immunoglobulin (IgG and IgA) and (IFN-γ) , (IL-8) concentration. Also, all these data were related to the results of the histological changes and the results of the urea CLO test of patients when compared with the noninfected members. These results showed highly significant differences among patient groups in comparison with noninfect-ed group at (P. Value < 0.001). On the other hand, there were no relationship between IgM con-centration with any of the other results of diagnostic methods were used may such results consid-ered a first step for determining the susceptibility of infection and to confirame the diagnosis by use one more test in each time especialy Histology (invasive teq.) and ECO rapid test (noninva-sive teq.) correlated with estimation of (IgG and IgA) and (IFN-γ), (IL-8) concentration
Graham, D. Y., Malaty, H. M., Evans, D. G., Evans Jr., D. J., Klein,P. D. and Adam, E. Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Elect of age, race, and socioeco-nomic status. Gastroenterology; 100: 1495-1501. (1991)
Kreiss, C., Blum, A. L. and Malfertheiner, P. Peptic ulcer patho-genesis. Curr. Opin. Gastroenterol; 11:25-31. (1995)
Correa P, Piazuelo MB. Evolutionary His-tory of the Helicobacter pylori Genome: Implications for Gastric Carcinogenesis. Gut Liver; 6: 21-28. (2012)
Suzuki H, Saito Y, Hibi T. Helicobacter pylori and Gastric Mucosaassociated Lym-phoid Tissue (MALT) Lymphoma: Updat-ed Review of Clinical Outcomes and the
Naji Comparative Study for the Accuracy of Helicobacter pylori Diagnostic Methods Associated with Some Inflammatory Factors 2017
Molecular Pathogenesis. Gut Liver; 3: 81-87. 2009.
Kienesberger, S., L. M. Cox, A. Livanos, X. S. Zhang, J. Chung, G. I. Perez-Perez, G. Gorkiewicz, E. L. Zechner and M. J. Blaser. Gastric Helicobacter pylori Infec-tion Affects Local and Distant Microbial Populations and Host Responses. Cell re-ports; 14(6): 1395-1407. 2016
Guarner J, Kalach N, Elitsur Y, Koletzko S. Helicobacter pylori diagnostic tests in children: review of the literature from 1999 to 2009. Eur J Pediatr; 169: 15-25. 2010.
Tian XY, Zhu H, Zhao J, She Q, Zhang GX. Diagnostic performance of urea breath test, rapid urea test, and histology for Heli-cobacter pylori infection in patients with partial gastrectomy: a meta-analysis. J Clin Gastroenterol; 46: 285-292. 2012.
Frenck RW, Fathy HM, Sherif M, Mohran Z, El Mohammedy H, Francis W, Rocka-brand D, Mounir BI, Rozmajzl P, Frierson HF. Sensitivity and specificity of various tests for the diagnosis of Helicobacter py-lori in Egyptian children. Pediatrics; 118:e1195-e1202. 2006.
Koletzko S, Jones NL, Goodman KJ, Gold B, Rowland M, Cadranel S, Chong S, Col-letti RB, Casswall T, Elitsur Y, Guarner J, Kalach N,Madrazo A, Megraud F, Oderda G. Evidence-based guidelines from ES-PGHAN and NASPGHAN for Helicobac-ter pylori infection in children. J Pediatr Gastroenterol Nutr; 53: 230-243. 2011.
Fan, X-G., Chua, A., Fan, X-J. and Keel-ing, P. W. N. Increased gastric production of interleukin-8 and tumour necrosis fac-torin patients with Helicobacter pylori in-fection. J. Clin. Pathol; 48:133-136. 1995.
Dixon, M. F., Genta, R. M., Yardley, J. H., Correa, P., Participants in the International Workshop on the Histopathology of Gas-tritis, Houston 1994 Classifcation, grading of gastritis. The updated Sydney System. Am. J. Surg. Pathol; 20:1161-1181. 1996.
Ando, T., Kusugami, K., Ohsuga, M., Shi-noda, M., Sakakibara, M., Saito, H., Fu-katsu, A., Ichiyma, S. and Ohta, M. Inter-leukin-8 activity correlates with histologi-cal severity in Helicobacter pylori-associated antral gastritis. Am. J. Gastroen-terol; 91: 1150-1156. 1996.
Yamaoka, Y., Kita, M., Kodama, T., Sawai, N., Kashima, K. and Imanishi, J. Expression of cytokine mRNA in gastric mucosa with Helicobacter pylori infection. Scand. J. Gastroenterol; 30: 1153-1159. 1995.
Quiding-Ja≪rbrink, M., Lundin, B. S., Lo≪nroth, H. and Svennerholm, A. -M. CD4+ and CD8+ T cell responses in Heli-cobacter pylori- infected individuals. Clin. Exp. Immunol; 123: 81-87. 2001.
Glupczynski, Y. The diagnosis of Helico-bacter pylori infection: a microbiologist’s perspective. Rev. Med. Microbiol; 5:199–208. 1994.
Lage, A., P. Gogforid, E. Fauconnier, A. Burette, A., Diagnosis of Helicobacter py-lori Infection by PCR: Comparison with Other Invasive Techniques and Detection of cagAGene in Gastric Biopsy Specimens. J. of Clin Microbiol; 33(10):2752-2755. 1995.
Miftahussurur, M., Y. Yamaoka. Diagnos-tic Methods of Helicobacter pylori Infec-tion for Epidemiological Studies: Critical Importance of Indirect Test Validation. Bi-oMed Res Int; 4: 419-423. 2016.
AK-Jumaily, S., T. Essa, R., H. Muhsin,I. ,M. Immunological study og gastric-ulcer patients infected with Helicobacter pylori. World J. of Pharmaceutical Research, 4(1):320-335. 2014.
Al-Jubori, S., S. Al_Kademy, M., S. Ali, M., R. Mohamed Ali., A. S.2016 Occur-rence of Helicobacter pylori among Iraqi patients with suspected gastric ulcer :histopathological study for mucosal biop-siesAdvancesces in Environmental Biolo-gy; 10(7): 224-230. 2016.
Cover, L., and M. J. Blaser. Helicobacter pylori in health and disease. Gastroenterol-ogy; 136(6):1863-1871. 2009.
Patel SK, Pratap CB, Jain AK, Gulati AK, Nath G. Diagnosis of Helicobacter pylori: What should be the gold standard? World J Gastroenterol;20:12847‑59. 2014.
Lee HC, Huang TC, Lin CL, Chen KY, Wang CK, Wu DC. Performance of Rou-tine Helicobacter pylori Invasive Tests in Patients with Dyspepsia. Gastroenterol Res Pract; 13:184-889. 2013.
Al-Mustansiriyah Journal of Science
ISSN: 1814-635X (print), ISSN: 2521-3520 (online) Volume 28, Issue 2, 2017 DOI: http://doi.org/10.23851/mjs.v28i2.xxx
Copyright © 2017 Authors and Al-Mustansiriyah Journal of Science. This work is licensed under a Creative Commons Attribution-
NonCommercial 4.0 International Licenses.
Gisbert JP, Calvet X, O’Connor A, Mégraud F, O’Morain CA. Sequential therapy for Helicobacter pylori eradication: a critical review. J Clin Gastroenterol; 44:313-325. 2010.
Logan,R. ,P. Walker,M. ,M. ABC of the upper gastrointestinal tract Epidemiology and diagnosis of Helicobacter pylori infec-tion. BMJ ;323(20):920-922. 2001.
Shah, H., P. Shah, M. Jarag, R. Shah, P. Shah, K. Naik. Prevalence of Helicobacter pylori infection in gastric and duodenal le-sions as diagnosed by endoscopic biopsy. Int J Med Sci Public Health; 5(1): 93-96. 2016.
Puetz T, Vakil N, Phadnis S, Dunn B, Rob-inson J. The Pyloritek test and the CLO test: accuracy and incremental cost analy-sis. Am J Gastroenterol; 92: 254-257. 1997.
Çakmak SK, Tantoglu BH, Onan D, Yorulmaz A,Tamer E, Artüz F. The fre-quency of Helicobacter pylori infection in vitiligo patients. Pigment Int;2:81-4. 2015.
She, C. R. ; Wilson, A. R. and Litwin, C. M. Evaluation of Helicobacter pylori Im-munoglobulin G (IgG), IgA, and IgM Se-rologic Testing Compared to Stool Antigen Testing. Clin Vaccine Immunol; 16(8): 1253–1255. 2009.
Bimczok, D. ; Grams, J. M. ; Stahl, R. D. ; Waites, K. B. ; Smythies, L. E. and Smith, P. D. Stromal regulation of human gastric dendritic cells restricts the Th1 response to Helicobacter pylori. Gastroenterology; 141: 929–38. 2011.
Holck, S., N rgaard, A., Bennedsen, M., Permin, H., Norn, S. and Andersen, L. P. Gastric mucosal cytokine resonses in Heli-cobacter pylori-infected patients with gas-tritis and peptic ulcers. Association with inflammatory parameters and bacterial load. FEMS Immunol. Med. Microbiol; 36: 175–180. 2003.
Peek, R. M. ; Jr. ; Fiske, C. and Wilson, K. T. Role of Innate Immunity in Helicobac-ter pylori-Induced Gastric Malignancy. Physiol Rev; 90(3): 831–858. 2010.
Ren, Z., Pang, G., Lee, R., Batey, R., Dunkley, M., Borody, T. and Clancy, R. Circulating T cell response to Helicobacter pylori infection in chronic gastritis. Heli-cobacter 5, 135–141. 2000.
Eaton, K. A., Mefford, M. and Thevenot, T. The role of T cell subsets and cytokines in the pathogenesis of Helicobacter pylori gastritis in mice. J. Immunol;166, 7456–7461. 2001.
Ramis, I. B., E. P. Moraes, M. S. Fer-nandes, R. Mendoza-Sassi, O. Rodrigues, C. R. Juliano, C. J. Scaini,P. E. Almeida da Silva. Evaluation of diagnostic methods for the detection of Helicobacter pylori in gas-tric biopsy specimens of dyspeptic pa-tients. Braz J Microbiol; 43(3):903-908. 2012.
Boklage, S. H., W. M. Allen, V. Ramamo-han, D. Mladsi, T. Wang. Impact of patient adherence on the cost-effectiveness of non-invasive tests for the initial diagnosis of Helicobacter pylori infection in the United States. Patient preference and adher-ence;10:45-55. 2016.
Al-Jubori, S., S. Al_Kademy,M., S. Ali, M. ,R. Mohamed Ali. ,A. S. Emergency of Helicobacter pylori resistance isolates ob-tained from Iraqi patients suffering Acute and chronic gastritis World J Pharm Sci; 4(7): 18-23. 2016.
How to Cite
The journal has no restrictions for the author to hold the copyrights of his articles. The journal does not allow authors to republish the same article in other journals or conferences that is published in one of its volumes.