Diagnostic value of serologric test for detection of Helicobacter pylori infection

Kwak, Inho

Abstract

BACKGROUND: Ever since Helicobacter pylori was discovered in 1983 by Warren and Marshall, many studies were conducted resulting in drastic change of the previous concept of gastrointestinal disorders and its treatment. Most people in developing countries are considered to be exposed to the organism at a very early age, being more susceptible to infection. This study was done to find out the diagnostic value of serology antibody test for Helicobacter pylori infection by comparing differences in those checked positive for H. pylori relative to their symptoms and findings on endoscopy, biopsy, and barium swallow.
METHODS
Subjects totaling 1240 who visited the Health Promotion Center of a university hospital were surveyed with questionnaire and were performed serology antibody test for H. pylori. 532 subjects underwent endoscopy and biopsy and in 708 subjects barium swallow was performed. All subjects were compared with respect to gastrointestinal symptoms, findings of pathology from the endoscopic and radiologic procedures with their antibody test results and titration.
RESULTS
Among 1240 patients, 804 (64.8%) were positive for Helicobacter pylori antibody. There were 449 males (68%), and 355 females (61%), which was statistically significant (p< 0.05).There was no difference in the positive rates of H. pylori according to smoking, drinking, and exercise. Higher prevalence of family history for gastric cancer was shown among those positive for H. pylori (p< 0.01). There was no difference noted in relation to gastric symptoms or past history of gastrointestinal disorders in the two groups. Relative to the gastric symptoms complained by the patients, the findings on endoscopy, biopsy and radiologic study, most of those checked positive for H. pylori were shown to have antibody titers in the range of 20 to 40 units/mL with 83.1% for symptoms, 83.6% for endoscopy, 84.8% for biopsy, 81.7% for barium swallow.
CONCLUSION
There was no significant difference among those positive and negative for serology antibody test with respect to gastrointestinal symptoms, findings on endoscopy, biopsy, and barium swallow in this study. But because H. pylori is associated with most of the gastrointestinal pathology, testing H. pylori with serology antibody method can be beneficial and useful for its accuracy in primary care setting where further investigation is not possible.