Comparison between invasive and noninvasive tests in diagnosis of Helicobacter pylori infection

Abstract

In this study, the invasive and noninvasive diagnotic tests were compared to choose the appropriate test for diagnostice of H. pylori infection. Helicobacter pylori (H. pylori) is a human pathogen that causes chronic gastritis, has a role in gastric and duodenal ulcer, is involved in gastric carcinogenesis and is regarded as a possible important factor in at least a subset of patients with functional dyspepsia. The diagnosis of H. pylori is an essential element in the management of many common gastrointestinal pathologies. The assessment of each routine invasive and noninvasive test is important. We studied a total of 127 outpatients for the detection of H. pylori infection. The presence of H. pylori infection by invasive tests containing the Rapid Urease Test (RUT), histology (Giemsa staining) and culture in 127 patients. Patients who were positive in culture, or two tests from four tests, invasive and noninvasive, were considered to have H. pylori infection. In noninvasive tests, we evaluated anti-H. pylori IgG and anti-CagA antibodies using commercial Enzyme-Linked Immunoassay (ELISA) and Western blot in dyspeptic patients. Eighty five out of the 127 patients were positive for H. pylori. Helicobacter pylori IgG seropositivity and 35 out of the 127 patients were positive for immunoblot. RUT had sensitivity, specifity and accuracy of 96, 80 and 90.5%, respectively; for Elisa these were 85.2, 33 and 70.5%, respectively and for ELISA with immunoblotting they were 65, 45 and 58.8%, respectively. The results of this study suggest that noninvasive tests (ELISA, immunoblotting) have the lowest and RUT with histology have the highest accuracy. These earlier tests can not be used for accurate infection diagnosis.