Brief Reports
Copyright ©2005 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 21, 2005; 11(3): 386-388
Published online Jan 21, 2005. doi: 10.3748/wjg.v11.i3.386
Accuracy of Helicobacter pylori stool antigen for the detection of Helicobacter pylori infection in dyspeptic patients
Ari Fahrial Syam, Abdul Aziz Rani, Murdani Abdullah, C. Manan, D. Makmun, M. Simadibrata, D. Djojoningrat, Daldiyono, Tadashi Sato
Ari Fahrial Syam, Abdul Aziz Rani, Murdani Abdullah, C. Manan, D. Makmun, M. Simadibrata, Daldiyono, D.Djojoningrat, Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia
Tadashi Sato, First Department of Medicine Yamanashi Medical University, Yamanashi, Japan
Author contributions: All authors contributed equally to the work.
Supported by Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia
Correspondence to: Ari Fahrial Syam, Jl Diponegoro No. 72 Jakarta Pusat 10430, Indonesia. ari_syam@hotmail.com
Telephone: +62-21-3153957 Fax: +62-21-3142454
Received: December 10, 2003
Revised: December 12, 2003
Accepted: January 30, 2004
Published online: January 21, 2005
Abstract

AIM: The premier platinum Helicobacter pylori (H pylori) stool antigen (HpSA) test is an enzyme immunoassay (EIA) that detects an H pylori antigen present in human stools. However, at present there is no uniformity about the cut off level required to consider the test as positive or negative. So we need the cut off level for our local population. The aim of this study was to evaluate the HpSA for the detection of H pylori infection in dyspeptic patients and to determine the sensitivity, specificity of the HpSA test in the diagnosis of H pylori infection, as compared to other standardized diagnostic techniques.

METHODS: Sixty-three dyspeptic patients were selected from patients who came to the Division of Gastrointestinal Clinic in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. H pylori infection was confirmed in all patients by histology and rapid urease test (CLO test). Positive results for H pylori were based on positive results from both rapid urea test and microscopic detection of H pylori. Stool specimens were analyzed for H pylori antigen using HpSA immunoassay.

RESULTS: A total 63 patients consisted of 31 (49.2%) males and 32 (50.8%) females ranging in ages between 16 and 73 years with a mean age of 42.4±15 years. The mean age of men was 43.2±15.7 years and women was 41.6±14.4 years. Endoscopic findings in this study included gastric cancer 1.6%, peptic ulcer 4.8%, duodenal ulcer 7.9%, esophagitis 6.3%, gastritis 77.7%, and gastroduodenitis 4.8%. According to the predefined study criteria, 6 (9.5%) of 63 patients were positive for H pylori. In the diagnosis of infection, the area under the receiver operating characteristic (ROC) curve for the HpSA test was 0.722 (95% CI, 0.518-0.927). Using a cut-off value of 0.274 instead of 0.16 (as recommended by the manufacturer) the sensitivity and the specificity were 66.7% and 78.9% respectively.

CONCLUSION: The HpSA stool test, using a cut-off value of 0.274, may be useful for the primary diagnosis of H pylori infection, its specificity is similar to other standard tests but its sensitivity was lower.

Keywords: Helicobacter pylori infection; Dyspepsia; HpSA; Enzyme Immunoassay