Lindsetmo RO, Johnsen R, Eide TJ, Gutteberg T, Husum HH, Revhaug A. Accuracy of Helicobacter pylori serology in two peptic ulcer populations and in healthy controls. World J Gastroenterol 2008; 14(32): 5039-5045 [PMID: 18763287 DOI: 10.3748/wjg.14.5039]
Corresponding Author of This Article
Rolv-Ole Lindsetmo, MD, PhD, MPH, Department of Gastrointestinal Surgery, University Hospital of North Norway, and Institute of Clinical Medicine, Tromsø University, Tromsø N-9036, Norway. rolv.ole.lindsetmo@unn.no
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World J Gastroenterol. Aug 28, 2008; 14(32): 5039-5045 Published online Aug 28, 2008. doi: 10.3748/wjg.14.5039
Accuracy of Helicobacter pylori serology in two peptic ulcer populations and in healthy controls
Rolv-Ole Lindsetmo, Roar Johnsen, Tor Jac Eide, Tore Gutteberg, Hanne Haukland Husum, Arthur Revhaug
Rolv-Ole Lindsetmo, Department of Gastrointestinal Surgery, University Hospital of North Norway and Institute of Clinical Medicine, Tromsø University, Tromsø N-9036, Norway
Roar Johnsen, Institute of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim N-7006, Norway
Tor Jac Eide, Department of Pathology, National Hospital, Oslo N-0027, Norway
Tore Gutteberg, Hanne Haukland Husum, Department of Microbiology, University Hospital of North Norway, Tromsø N-9036, Norway
Arthur Revhaug, Department of Gastrointestinal Surgery, University Hospital of North Norway and Institute of Clinical Medicine, Tromsø University, Tromsø N-9036, Norway
Author contributions: All authors have made substantial contributions to interpretation of data, participated in drafting of the article and revised it critically for important intellectual content and have given final approval of the manuscript to be submitted and published; Lindsetmo RO, Johnsen R and Revhaug A made the conception and design; Lindsetmo RO, Eide TJ, Gutteberg T and Husum HH acquired the data; Lindsetmo RO wrote the paper.
Correspondence to: Rolv-Ole Lindsetmo, MD, PhD, MPH, Department of Gastrointestinal Surgery, University Hospital of North Norway, and Institute of Clinical Medicine, Tromsø University, Tromsø N-9036, Norway. rolv.ole.lindsetmo@unn.no
Telephone: +47-77-626000 Fax: +47-77-626605
Received: March 10, 2008 Revised: August 13, 2008 Accepted: August 20, 2008 Published online: August 28, 2008
Abstract
AIM: To estimate the test characteristics of Helicobacter pylori (H pylori) serology and of C14-urea breath test (C14-UBT) in two different peptic ulcer populations and in community controls. Second, the aim was to explore the association between the level of H pylori IgG antibodies and severity of inflammation as to active peptic ulceration in the same populations.
METHODS: Vagotomized (n = 83), medically treated peptic ulcer patients (n = 73) and one reference group of community controls (n = 88) were gastroscoped. H pylori status was determined by histology, bacterial growth, C14-UBT and serology. Based on the updated Sydney System, cumulative scores from biopsies from the prepyloruos, incisura angularis, corpus and fundus were calculated.
RESULTS: The prevalence of H pylori infection varied from 70% to 79%. The C14-UBT had high accuracy compared to the serology test. The sensitivity of the serology test was good, but the specificity was low (41%-71%). The association between H pylori IgG antibodies and scores of gastric mucosal inflammation and current or previous peptic ulcer were weak.
CONCLUSION: The accuracy of C14-UBT to diagnose H pylori infection was good, and the clinical utility of a negative H pylori serology test was substantial, while the gain in clinical information of a positive test was meagre. Positive H pylori titres could not distinguish between subjects with or those without active peptic ulceration.
