Document Type : Original Research
Gastrointestinal & Liver Disease Research Center (GILDRC), Iran University of Medical Sciences, Tehran, Iran
Dept. of Virology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
Dept. of Internal Medicine, Amiralmomenin hospital, Arak University of Medical Sciences, Arak, Iran
Dept. of Pathology, Amiralmomenin hospital, Arak University of Medical Sciences, Arak, Iran
Dept. of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Immunology Research Center, Institute of Immunology and Infectious diseases, Iran University of Medical Sciences, Tehran, Iran
Background and Objectives: Iran, as a developing country, is experiencing high burdens of Helicobacter pylori (Hp)-associated non-communicable diseases. Hp stool antigen test (HpSA) is widely used as an inexpensive and feasible noninvasive method to diagnose Hp infection, instead of invasive approaches. The current study aimed at evaluating the diagnostic and predictive values of HpSA test for Hp infection in Iranian patients with dyspepsia.
Materials and methods: The current cross sectional study was performed on 100 patients with dyspepsia. Gastric mucosal specimens were taken, processed, and examined according to the standard protocols. Simultaneously, stool samples were obtained and sent to laboratory for further analyses. Hp stool antigen titers were assessed using enzyme-linked immunosorbent assay (ELISA) technique.
Results:Stool antigen titers were not associated with gender (P-value=0.284), but correlated to age (r=0.213, P-value=0.034).Considering0.385 as a cutoff point, the HpSA test had 80.4% sensitivity and 85.7% specificity.
Conclusion: Based on cost-effectiveness of HpSA test, the current study findings corroborated the use of HpSA test to detect and follow-up patients with Hp infection, as an alternative method to detect Hp rather than invasive procedures.
- McColl KE. Clinical practice. Helicobacter pylori infection. The New England journal of medicine. 2010;362(17):1597-604.
- Zhao Y, Wang J, Tanaka T, Hosono A, Ando R, Soeripto S, et al. Association between HLA-DQ genotypes and haplotypes vs Helicobacter pylori infection in an Indonesian population. Asian Pacific journal of cancer prevention : APJCP. 2012;13(4):1247-51.
- Stool Antigen Tests for Helicobacter pylori Infection: A Review of Clinical and Cost-Effectiveness and Guidelines. CADTH Rapid Response Reports. Ottawa (ON)2015.
- Brown LM, Thomas TL, Ma JL, Chang YS, You WC, Liu WD, et al. Helicobacter pylori infection in rural China: demographic, lifestyle and environmental factors. International journal of epidemiology. 2002;31(3):638-45.
- Ghotaslou R, Milani M, Akhi MT, Nahaei MR, Hasani A, Hejazi MS, et al. Diversity of Helicobacter Pylori cagA and vacA Genes and Its Relationship with Clinical Outcomes in Azerbaijan, Iran. Advanced pharmaceutical bulletin. 2013;3(1):57-62.
- Miernyk K, Morris J, Bruden D, McMahon B, Hurlburt D, Sacco F, et al. Characterization of Helicobacter pylori cagA and vacA genotypes among Alaskans and their correlation with clinical disease. Journal of clinical microbiology. 2011;49(9):3114-21.
- Wang YK, Kuo FC, Liu CJ, Wu MC, Shih HY, Wang SS, et al. Diagnosis of Helicobacter pylori infection: Current options and developments. World journal of gastroenterology. 2015;21(40):11221-35.
- Patel SK, Pratap CB, Jain AK, Gulati AK, Nath G. Diagnosis of Helicobacter pylori: what should be the gold standard? World journal of gastroenterology. 2014;20(36):12847-59.
- Khalifehgholi M, Shamsipour F, Ajhdarkosh H, Ebrahimi Daryani N, Pourmand MR, Hosseini M, et al. Comparison of five diagnostic methods for Helicobacter pylori. Iranian journal of microbiology. 2013;5(4):396-401.
- Kalem F, Ozdemir M, Baysal B. [Investigation of the presence of Helicobacter pylori by different methods in patients with dyspeptic complaints]. Mikrobiyoloji bulteni. 2010;44(1):29-34.
- Lopes AI, Vale FF, Oleastro M. Helicobacter pylori infection - recent developments in diagnosis. World journal of gastroenterology. 2014;20(28):9299-313.
- Redeen S, Petersson F, Tornkrantz E, Levander H, Mardh E, Borch K. Reliability of Diagnostic Tests for Helicobacter pylori Infection. Gastroenterology research and practice. 2011;2011:940650.
- Schulz TR, McBryde ES, Leder K, Biggs BA. Using stool antigen to screen for Helicobacter pylori in immigrants and refugees from high prevalence countries is relatively cost effective in reducing the burden of gastric cancer and peptic ulceration. PloS one. 2014;9(9):e108610.
- Peng NJ, Lai KH, Lo GH, Hsu PI. Comparison of noninvasive diagnostic tests for Helicobacter pylori infection. Medical principles and practice : international journal of the Kuwait University, Health Science Centre. 2009;18(1):57-61.
- Lario S, Ramirez-Lazaro MJ, Montserrat A, Quilez ME, Junquera F, Martinez-Bauer E, et al. Diagnostic accuracy of three monoclonal stool tests in a large series of untreated Helicobacter pylori infected patients. Clinical biochemistry. 2016.
- Osman HA, Hasan H, Suppian R, Bahar N, Hussin NS, Rahim AA, et al. Evaluation of the Atlas Helicobacter pylori stool antigen test for diagnosis of infection in adult patients. Asian Pacific journal of cancer prevention : APJCP. 2014;15(13):5245-7.
- Malekzadeh F, Sepanlou SG, Poustchi H, Naghavi M, Forouzanfar MH, Shahraz S, et al. Burden of Gastrointestinal and Liver Diseases in Iran: Estimates Based on the Global Burden of Disease, Injuries, and Risk Factors Study, 2010. Middle East journal of digestive diseases. 2015;7:138-54.
- Sepanlou SG, Malekzadeh F, Naghavi M, Forouzanfar MH, Shahraz S, Moradi-Lakeh M, et al. Trend of Gastrointestinal and Liver Diseases in Iran: Results of the Global Burden of Disease Study, 2010. Middle East journal of digestive diseases. 2015;7:121-37.
- Calik Z, Karamese M, Acar O, Aksak Karamese S, Dicle Y, Albayrak F, et al. Investigation of Helicobacter pylori antigen in stool samples of patients with upper gastrointestinal complaints. Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology]. 2016;47(1):167-71.
- Douraghi M, Nateghi Rostami M, Goudarzi H, Ghalavand Z. Comparison of stool antigen immunoassay and serology for screening for Helicobacter pylori infection in intellectually disabled children. Microbiology and immunology. 2013;57(11):772-7.
- Korkmaz H, Findik D, Ugurluoglu C, Terzi Y. Reliability of stool antigen tests: investigation of the diagnostic value of a new immunochromatographic Helicobacter pylori approach in dyspeptic patients. Asian Pacific journal of cancer prevention : APJCP. 2015;16(2):657-60.
- Lee YC, Chiu HM, Chiang TH, Yen AM, Chiu SY, Chen SL, et al. Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions. BMJ open. 2013;3(10):e003989.
- Lee YC, Tseng PH, Liou JM, Chen MJ, Chen CC, Tu CH, et al. Performance of a one-step fecal sample-based test for diagnosis of Helicobacter pylori infection in primary care and mass screening settings. Journal of the Formosan Medical Association = Taiwan yi zhi. 2014;113(12):899-907.
- Segamwenge IL, Kagimu M, Ocama P, Opio K. The utility of the Helicobacter pylori stool antigen test in managing dyspepsia: an experience from a low resource setting. African health sciences. 2014;14(4):829-34.
- Sharbatdaran M, Kashifard M, Shefaee S, Siadati S, Jahed B, Asgari S. Comparison of stool antigen test with gastric biopsy for the detection of Helicobacter Pylori infection. Pakistan journal of medical sciences. 2013;29(1):68-71.
- Ghahremani H, Farshad S, Amini Najafabadi H, Kashanian S, Momeni Moghaddam MA, Moradi N, et al. Characteristics of 26 kDa antigen of H. Pylori by Monoclonal Antibody. Iranian journal of allergy, asthma, and immunology. 2015;14(1):113-9.
- Shimoyama T. Stool antigen tests for the management of Helicobacter pylori infection. World journal of gastroenterology. 2013;19(45):8188-91.
- Raguza D, Machado RS, Ogata SK, Granato CF, Patricio FR, Kawakami E. Validation of a monoclonal stool antigen test for diagnosing Helicobacter pylori infection in young children. Journal of pediatric gastroenterology and nutrition. 2010;50(4):400-3.
- Miftahussurur M, Yamaoka Y. Diagnostic Methods of Helicobacter pylori Infection for Epidemiological Studies: Critical Importance of Indirect Test Validation. BioMed research international. 2016;2016:4819423.