Comparison of Accuracy of Diagnostic Tests of Helicobacter pylori Infection in Children

Lee, Seon Young; Kim, Han Seong; Seo, Jeong Kee

Abstract

BACKGROUND/AIMS: Our aim was to compare the sensitivity, specificity, and predictive value of tests frequently used for diagnosis of Helicobacter pylori in children.
METHODS
A total of 486 children (mean age; 9.6+/-4.0 years) were tested for detecting H. pylori infection by measuring IgG antibody level, examing antral biopsy specimens for Giemsa stain, CLO test, culture, and observing the presence of neutrophils and mononuclear cells after H&E staining during 5-year period. The severity of neutrophil and mononuclear cell infiltration were graded by scale from 0 (none) to 3 (severe). H. pylori infection for each patient was defined as the case to show positivity in three or more of the six test parameters.
RESULTS
One hundred and sixty children (32.9%) were considered to be H. pylori positive. Giemsa staining had apparently the best sensitivity and specificity, but they were not statistically different from those of CLO test and IgG serology in determining the correct diagnosis. The positive predictive values for acute and chronic inflammation were increased according to the degrees of inflammation.
CONCLUSIONS
The choice of diagnostic modality to determine H. pylori infection status will depend on test availability, ease of use, H. pylori treatment history.