Diagnostic accuracy of tests for Helicobacter pylori in an Alaska Native population

AIM： TO evaluate the accuracy of two non-invasive tests in a population of Alaska Native persons. High rates of Helicobacter pylori （H. pylon] infection, H. pyIori treatment failure, and gastric cancer in this population necessitate documentation of infection status at multiple time points over a pa...

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Bibliographic Details
Published in:World journal of gastroenterology : WJG 2011-11, Vol.17 (42), p.4682-4688
Main Authors: Bruden, Dana L, Bruce, Michael G, Miernyk, Karen M, Morris, Julie, Hurlburt, Debby, Hennessy, Thomas W, Peters, Helen, Sacco, Frank, Parkinson, Alan J, McMahon, Brian J
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alaska - epidemiology
Antibodies, Bacterial - blood
Breath Tests - methods
Brief
Diagnostic Tests, Routine - standards
Endoscopy, Gastrointestinal
Female
Helicobacter Infections - complications
Helicobacter Infections - diagnosis
Helicobacter Infections - epidemiology
Helicobacter pylori - immunology
Humans
Male
Middle Aged
Population Groups
Predictive Value of Tests
Sensitivity and Specificity
Stomach Neoplasms - diagnosis
Stomach Neoplasms - etiology
Urea - metabolism
Urease - metabolism
Young Adult
人口
准确率
原住民
幽门螺旋杆菌
幽门螺杆菌
抗体检测
测试
阿拉斯加
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Summary:AIM： TO evaluate the accuracy of two non-invasive tests in a population of Alaska Native persons. High rates of Helicobacter pylori （H. pylon] infection, H. pyIori treatment failure, and gastric cancer in this population necessitate documentation of infection status at multiple time points over a patient＇s life.urease test, 13C urea breath test （UBT）, and immunoglobulin G antibodies to H. pylori in serum. The performances of 13C-UBT and antibody test were compared to a gold standard defined by a positive H. pylori test by culture or, in case of a negative culture result, by positive histology and a positive rapid urease test. RESULTS： The sensitivity and specificity of the 13C- UBT were 93% and 88%, respectively, relative to the gold standard. The antibody test had an equivalent sensitivity of 93% with a reduced specificity of 68%. The false positive results for the antibody test were associated with previous treatment for an H. pylorlinfection [relative risk （RR） = 2.8]. High levels of antibodies to H. py/or/were associated with chronic gastritis and male gender, while high scores in the 13C-UBT test were associated with older age and with theH. pylori bacteria load on histological examination （RR = 4.4）. CONCLUSION： The 13C-UBT outperformed the antibody test for H. pylori and could be used when a noninvasive test is clinically necessary to document treatment outcome or when monitoring for reinfection.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v17.i42.4682