Helicobacter Pylori Antibody Test Research Articles

Significance of pepsinogen in screening for gastric intestinal metaplasia in Guangdong, China.

ObjectiveDiagnosis of gastric intestinal metaplasia (GIM) relies on gastroscopy and histopathologic biopsy, but their application in screening for GIM is limited. We aimed to identify serological biomarkers of GIM via screening in Guangdong, China.MethodsCross-sectional field and questionnaire data, demographic information, past medical history, and other relevant data were collected. Blood samples were collected for pepsinogen (PG)I, PGII, gastrin-17, and Helicobacter pylori antibody testing, and gastroscopy and histopathologic biopsy were performed. Single factor and logistic regression analyses were used to evaluate the correlation between these indicators and GIM, and decision tree models were used to determine the cut-off points between indicators.ResultsOf 443 participants enrolled, 87 (19.6%) were diagnosed with GIM. Single factor analysis showed that pepsin indicators (PGI, PGII, and PGI/PGII ratio) and the factors Mandarin as native language, urban residency, hyperlipidemia, and age were associated with GIM. Logistic regression analysis showed that PGI and age were associated with GIM.ConclusionsAge is an important factor for predicting GIM progression; age >60 years increased its risk. Detection of GIM was higher in individuals with PGI levels >127.20 ng/mL, which could be used as a threshold indicating the need to perform gastroscopy and histopathologic biopsy.

Cost-effectiveness of Helicobacter pylori test and eradication versus upper gastrointestinal series versus endoscopy for gastric cancer mortality and outcomes in high prevalence countries

Background: The latest version of Japanese guidelines for effective secondary prevention of gastric cancer recommend upper gastrointestinal series (UGI) and endoscopy in adults 50 years of age and older. A Helicobacter pylori antibody test and eradication (H. pylori screening) reduces gastric cancer risk.Objective: This study aimed to evaluate the cost-effectiveness of H. pylori screening, compared to UGI and endoscopy in high prevalence countries.Methods: We developed decision trees with Markov models using a healthcare payer perspective and a lifetime horizon. Targeted populations were hypothetical cohorts of asymptomatic individuals at the age of 50, 60, 70 and 80 years. We calculated per-person costs and effectiveness with discounting at a fixed annual rate of 3% and compared incremental cost-effectiveness ratios.Results: H. pylori screening was cost-saving and more cost-effective for individuals at the age of 50, 60, 70, and 80 than UGI and endoscopy. One-way and multiway sensitivity analyses showed the robustness of the cost-effectiveness results. Probabilistic sensitivity analyses using Monte-Carlo simulation for 10,000 trials demonstrated that H. pylori screening was cost-effective 100% of the time at a willingness-to-pay level of US$50,000/QALY gained.Conclusions: H. pylori screening for the adults 50 years of age and older could be cost-effective compared to UGI and endoscopy in high prevalence countries. The main reasons for the superiority of H. pylori screening are that an H. pylori antibody test has a higher sensitivity and specificity than UGI and endoscopy and the benefits to reduce gastric cancer incidence and mortality.

Update version of the Japanese Guidelines for Gastric Cancer Screening

Although the incidence and mortality of gastric cancer have gradually decreased, its burden remains in East Asian countries. Gastric cancer screening has been performed in Japan since 1983, and the introduction of new screening techniques has been eagerly anticipated. To promote evidence-based screening, the Japanese guidelines for gastric cancer screening have been revised based on the new studies. The guidelines for gastric cancer screening have been developed according to a previously established method. To assess evidence regarding the effectiveness of the screening methods, a systematic review was conducted based on an analytic framework including clinical questions aiming at reducing mortality from gastric cancer. The following methods were assessed for gastric cancer screening: upper gastrointestinal series (radiographic screening), gastrointestinal endoscopy (endoscopic screening), Helicobacter pylori antibody test and serum pepsinogen tests. Based on the balance of the benefits and harms of each screening method, recommendations for population-based and opportunistic screenings were formulated. After the Japanese guidelines for gastric cancer screening were published in 2005, several observational studies on radiographic and endoscopic screenings have been reported. Three case-control studies have evaluated mortality reduction from gastric cancer by endoscopic screening. Notably, evidence of the H. pylori antibody and serum pepsinogen tests was insufficient. Although false-positive results, false-negative results, and complications were observed in endoscopic and radiographic screenings, the complication rates were higher in endoscopic screening than in radiographic screening. Overdiagnosis was not estimated directly in both methods. Radiographic and endoscopic screenings for gastric cancer are recommended for population-based and opportunistic screenings. The H. pylori antibody and serum pepsinogen tests are not recommended for population-based screening because of insufficient evidence.

Prevalence of <i>Helicobacter pylori</i> IgG and stool antigen detection from dyspeptic patients in Jos, Nigeria

Helicobacter pylori is a helical shaped gram negative microaerophilic bacterium , that can inhabit various areas of the stomach. The study was carried out to determine the prevalence of Helicobacter pylori infection among dyspeptic patients attending Endoscopy unit, Jos University Teaching Hospital (JUTH). The prevalence of H pylori ; antibodies in plasma and antigen in stool samples of 80 patients examined was studied using ELISA (DIA PRO, Italy) and ICA (BIOTEST China) respectively. Sociodemographic and clinical information was obtained through the assistance of attending gastroenterology staff. Blood grouping was also performed by slide agglutination test for all patients. Helicobacter pylori IgG antibodies were detected in plasma of 28 (35%) patients of which 27 patients out of the sero-positive cases were antigen positive while Helicobacter pylori antigen was detected in the stool of 31 (38.8%) patients of which 27 patients out of the antigen positive cases were also seropositve. No significant association was found between Helicobacter pylori and age, sex, ABO blood group, economic status, source of water and consumption of alcohol. Thus, Helicobacter pylori seropositivity with respect to blood groups was found to be 32.6%, 46.7%, 33.3% and 33.3% in blood groups O, B, A and AB respectively, while Helicobacter pylori stool antigen test positive results was found to be 33.3%, 33.3%, 46% and 39.5% in blood groups O, B, A and AB respectively. Hence, no statistical association was found between Helicobacter pylori infection and blood groups of the patients (P>0.05). However, marital status was significantly associated with Helicobacter pylori antibody test (P<0.05). There is need for government to encourage people about the Helicobacter pylori screening test since it is one of the etiologic agent of ulcer. Keywords : Helicobacter pylori , Jos, Peptic ulcer, Prevalence.

Su1980 Combining the Serum Pepsinogen Levels and Helicobacter pylori Antibody Test Is Not Useful for Detecting Gastric Neoplasms With Advanced Histology

Background: Combining serum pepsinogen (PG) levels and Helicobacter pylori antibody test is useful for detecting high-risk population for gastric neoplasm. We tried to uncover whether this combinationmethod can predict the incidence and histology of gastric neoplasm. Methods: This study included 3946 asymptomatic Korean adults who underwent esophagogastroduodenoscopy with blood testing for PG levels and H. pylori antibody on the same day at our center. Subjects with extragastric malignancy, a history of H. pylori eradication or gastric neoplasm, or recent antacid medication were excluded. Gastric atrophy was defined as serum PG I of ≤ 70 ng/ml and PG I/II ratio of ≤ 3.0. The subjects were classified into four groups according to the presence (+) and absence (-) of gastric atrophy and H. pylori infection. Results: Of the 3328 included subjects, 17 were incidentally diagnosed as having either gastric adenoma or carcinoma. While the incidence of gastric neoplasm was highest in the gastric atrophy(+)/H. pylori(-) group (4.17%; odds ratio=25.8; p=0.009), this group exhibited the least advanced histology, such as gastric adenoma with low-grade dysplasia (LGD). The gastric atrophy(-)/H. pylori(-) group exhibited the lowest incidence of gastric neoplasm (0.17%) but the most-advanced histology, such as poorly cohesive carcinoma and adenoma with high-grade dysplasia. Conclusions: Combining serum PG levels and H. pylori antibody testing is useful for detecting gastric neoplasms progressing from gastric adenoma with LGD to differentiated, Lauren's intestinal-type gastric cancer based on the slow gastric carcinogenesis pathway. However, this method is not useful for detecting gastric neoplasms with advanced histology.

Su1981 The Role of H. Pylori Eradication for the Prevention of Metachronous Lesions After Endoscopic Resection in Gastric Neoplasms

Background: Combining serum pepsinogen (PG) levels and Helicobacter pylori antibody test is useful for detecting high-risk population for gastric neoplasm. We tried to uncover whether this combinationmethod can predict the incidence and histology of gastric neoplasm. Methods: This study included 3946 asymptomatic Korean adults who underwent esophagogastroduodenoscopy with blood testing for PG levels and H. pylori antibody on the same day at our center. Subjects with extragastric malignancy, a history of H. pylori eradication or gastric neoplasm, or recent antacid medication were excluded. Gastric atrophy was defined as serum PG I of ≤ 70 ng/ml and PG I/II ratio of ≤ 3.0. The subjects were classified into four groups according to the presence (+) and absence (-) of gastric atrophy and H. pylori infection. Results: Of the 3328 included subjects, 17 were incidentally diagnosed as having either gastric adenoma or carcinoma. While the incidence of gastric neoplasm was highest in the gastric atrophy(+)/H. pylori(-) group (4.17%; odds ratio=25.8; p=0.009), this group exhibited the least advanced histology, such as gastric adenoma with low-grade dysplasia (LGD). The gastric atrophy(-)/H. pylori(-) group exhibited the lowest incidence of gastric neoplasm (0.17%) but the most-advanced histology, such as poorly cohesive carcinoma and adenoma with high-grade dysplasia. Conclusions: Combining serum PG levels and H. pylori antibody testing is useful for detecting gastric neoplasms progressing from gastric adenoma with LGD to differentiated, Lauren's intestinal-type gastric cancer based on the slow gastric carcinogenesis pathway. However, this method is not useful for detecting gastric neoplasms with advanced histology.

The Japanese Guidelines for Gastric Cancer Screening

Gastric cancer is the leading cause of death from cancer in Japan. In 2004, there were 50 562 deaths from gastric cancer; they accounted for 15.8% of the total number of cancer deaths. Since 1983, under the Health Service Law for the Aged, gastric cancer screening has been conducted nationwide for all residents aged 40 years and over. On the basis of the standardized method developed for the Japanese Guidelines for Cancer Screening, the efficacies of various methods for gastric cancer screening were evaluated and the guideline was developed. Four methods for gastric cancer screening were evaluated: photofluorography, endoscopy, serum pepsinogen testing and Helicobacter pylori antibody testing. On the basis of the analytic framework involving key questions, 1715 articles, published from January 1985 to February 2005, were selected using MEDLINE, the Japanese Medical Research Database and other methods. After the systematic literature review, 10 articles were identified as direct evidence and 49 articles as indirect evidence. The studies that evaluated mortality reduction from gastric cancer included five case-control and two cohort studies for radiographic screening. On the basis of the balance of benefits and harms, the recommendations for population-based and opportunistic screening were formulated. Gastric cancer screening using photofluorography was recommended for both screening programs. The other methods were not recommended for population-based screening due to insufficient evidence. The guideline for gastric cancer screening guideline was developed based on the previously established method. Gastric cancer screening using photofluorography is recommended for population-based and opportunistic screening in Japan.

Helicobacter pylori Infection in Five Inpatient Units for People with Intellectual Disability and Psychiatric Disorder

Background A high prevalence of Helicobacter pylori infection has been reported among people with intellectual disability, especially those residing in hospital and similar settings. Surveys of inpatients have found unusually high rates of gastrointestinal malignancy, to which H. pylori infection predisposes.Methods Helicobacter pylori antibody testing was arranged for all residents of five inpatient units for people with intellectual disability and challenging behaviour or psychiatric disorder. Eradication triple therapy was prescribed for those people with a positive result. 13C urea breath testing was attempted after eradication therapy.Results Thirty‐seven residents were identified. It was possible to obtain blood for H. pylori antibody testing for 36 people. Twenty‐two (59%) had a positive result. Dividing the people studied according to length of stay in hospital showed that 4 of the 18 people resident in hospital for &lt;4 years (22%) had a positive antibody test, compared with 16 of the 19 people resident in hospital for ≥4 years (84%; χ2 = 14.6; P &lt; 0.001). Treatment led to eradication of H. pylori infection in 11 of the 12 people who were able to cooperate with testing.Conclusions Clinicians should have a high index of suspicion for H. pylori infection among people with intellectual disability who have a history of institutional care or prolonged hospital admission, especially those who have spent more than 4 years in such settings. Testing for H. pylori antibodies is well tolerated. Eradication therapy offers many health benefits, including a reduction of the risk for stomach malignancies.

AccuStat whole blood fingerstick test for Helicobacter pylori infection: a reliable screening method.

Helicobacter pylori antibody testing is accurate for diagnosing untreated patients. Rapid serum testing is as accurate as formal enzyme-linked immunosorbent assay (ELISA) testing. As whole blood fingerstick tests may become the diagnostic method of choice if they are of similar accuracy, 51 patients were studied who had not taken antibiotics, bismuth, sucralfate, or proton pump inhibitors. Concordance between C-14 Urea Breath Testing and HM-CAP ELISA testing served as the study standard for H. pylori diagnosis. Rapid antibody testing was performed with the AccuStat whole blood (Boehringer Mannheim, Mannheim, Germany) and FlexSure HP (Smith Kline Diagnostics, San Jose, CA) serum tests. Antral biopsy for CLO testing and histological evaluation with thiazine staining were available for 18 (35.3%) and 20 patients (39.2%), respectively. Nineteen of 50 patients (38%) were infected. (One patient had discordant tests and was excluded.) FlexSure HP and AccuStat were each positive in 18 (36%) and 19 patients (38%) with sensitivity, specificity, and positive and negative predictive values of 89.5% and 89.5%, 96.8% and 93.5%, 94.4% and 89.5%, and 93.8% and 93.5%, respectively. There were two false-negative FlexSure HP and AccuStat tests and three false-positive tests--1 FlexSure and 2 AccuStat results. CLO test and histology concurred in every case tested. We conclude that both rapid antibody tests are accurate and suitable for screening patients not previously treated for H. pylori infection. Since the AccuStat has preserved diagnostic strength, is less costly, takes less time, and is less labor intensive, whole blood testing is the screening test of choice.