Value of CIM, CLO Test and Multiplex PCR for the Diagnosis of Helicobacter Pylori Infection Status in Patients with Gastritis and Gastric Ulcer.

Tran Thien Trung,Tran Anh Minh,Nguyen Tuan Anh

doi:10.31557/apjcp.2019.20.11.3497

Abstract

Objective:To assess the value of Current Infection Marker (CIM) test, Campylobacter-Like Organism (CLO) test, and the multiplex polymerase chain reaction test (PCR) for the diagnosis of Helicobacter pylori (H. pylori) infection in a Vietnamese population. Methods:Targeted suitable patients were recruited. CIM test, CLO test and multiplex PCR were used to diagnose for H. pylori infection. Patients were considered positive for H. pylori when at least two of the three tests were positive. The performance of each of the three tests was compared to the H. pylori positive populations as defined. Result:Amongst 201 patients with a mean age of 40.5 (range, 18-74) years, there were 115 females and 86 males. Of the 201 patients, 107 (53.2%) were diagnosed as H. pylori positive according to the defined criteria. The positive patients obtained with CLO test, CIM test and multiplex PCR were 38.3%, 59.2% and 72.1%, correspondingly. The full performance of the three tests as highlighted in order as above were 85.07%, 83.08% and 81.09%, respectively. The positive rate of CLO test was the lowest, with 38.3% positive, but this method was the most accurate, with the accuracy of 85.07%. This suggested that CLO test has the highest specificity among the three. The sensitivity, specificity, positive, negative predictive values and accuracy of the CLO / CIM / multiplex PCR tests were 71.96% / 89.72% / 100%, 100% / 75.53% / 59.57%, 100% / 80.67% / 73.79%, 75.81% / 86.59% / 100%, and 85.07% / 83.08% / 81.09%, respectively. Conclusion:All the three methods have high accuracy for the diagnosis of H. pylori infection in the Vietnamese population with gastritis and gastric ulcers. These tests can be employed in the clinical settings for the Vietnamese population. CLO test should be used in combination with the other tests to reduce false-negative results.

Highlights

H. pylori is a bacterium involving directly in the pathogenesis of various gastroduodenal diseases, especially gastric cancer (Pellicano et al, 2016)
Current Infection Marker (CIM) test, Campylobacter-Like Organism (CLO) test and multiplex polymerase chain reaction test (PCR) were used to diagnose for H. pylori infection
The majority of patients were diagnosed with gastritis (96.0%; 193/201); only a small percentage was diagnosed with gastric ulcer (4.0%; 8/201)

Summary

Introduction

H. pylori is a bacterium involving directly in the pathogenesis of various gastroduodenal diseases, especially gastric cancer (Pellicano et al, 2016). The prevalence of H. pylori infection varies across countries worldwide. The prevalence of H. pylori infection is about 25-50% in developed countries, but more than 80% in the developing ones (Hosseini et al, 2012). In Vietnam, the prevalence of H. pylori infection ranges from 65.6% to more than 74.6% (Fock and Ang, 2010; Nguyen et al, 2010), 78.8% in Hanoi (Hoang et al, 2005) and 80.5% in Ho Chi Minh city (Binh et al, 2017). It is proven that H. pylori infection is one of the etiology of conditions such as gastritis, peptic ulcer and gastric cancer. Accurate clinical diagnosis for the treatment of H. pylori infection is crucial for the infected population

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Results

Conclusion