Pepsinogen and Serum IgG Detection Is a Valuable Diagnostic Method for Helicobacter pylori Infection in a Low-Prevalence Country: A Report from Sri Lanka.

Autor: Doohan D; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia., Fauzia KA; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia.; Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya 60115, Indonesia., Rathnayake J; Department of Surgery, Teaching Hospital Peradeniya, University of Peradeniya, Kandy 20404, Sri Lanka., Lamawansa MD; Department of Surgery, Teaching Hospital Peradeniya, University of Peradeniya, Kandy 20404, Sri Lanka., Waskito LA; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia., Tuan VP; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh 749000, Vietnam., Dashdorj A; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan., Kabamba ET; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Research Center for Infectious Sciences, Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka 545-8585, Japan., Phuc BH; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan., Ansari S; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Department of Microbiology, Teaching Hospital, Chitwan Medical College, Bharatpur 44200, Nepal., Akada J; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan., Matsumoto T; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan., Uchida T; Department of Molecular Pathology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan., Matsuhisa T; Department of Gastroenterology, Tama Nagayama University Hospital, Nippon Medical School, Tokyo 206-8512, Japan., Yamaoka Y; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX 77030, USA.; Global Oita Medical Advanced Research Center for Health (GO-MARCH), Faculty of Medicine, Oita University, Yufu 879-5593, Japan.; Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya 60115, Indonesia.
Jazyk: angličtina
Zdroj: Diagnostics (Basel, Switzerland) [Diagnostics (Basel)] 2021 Jul 29; Vol. 11 (8). Date of Electronic Publication: 2021 Jul 29.
DOI: 10.3390/diagnostics11081364
Abstrakt: The use of serum anti- Helicobacter pylori IgG and pepsinogen (PG) detection as a diagnostic method was evaluated in Sri Lanka. Gastric biopsies were performed (353 patients), and the prevalence of H. pylori infection was 1.7% (culture) and 2.0% (histology). IgG serology testing showed an area under the curve (AUC) of 0.922 (cut-off, 2.95 U/mL; specificity, 91.56%; sensitivity, 88.89%). Histological evaluation showed mild atrophy (34.3%), moderate atrophy (1.7%), metaplasia (1.7%), chronic gastritis (6.2%), and normal tissue (56%). The PGI/PGII ratio was significantly higher in H. pylori- negative patients ( p < 0.01). PGII and PGI/PGII levels were lower in patients with metaplasia than in those with normal mucosa ( p = 0.049 and p < 0.001, respectively). The PGI/PGII ratio best discriminated metaplasia and moderate atrophy (AUC 0.88 and 0.76, respectively). PGI and PGII alone showed poor discriminative ability, especially in mild atrophy (0.55 and 0.53, respectively) and chronic gastritis (0.55 and 0.53, respectively). The best cut-off to discriminate metaplasia was 3.25 U/mL (95.19% specificity, 83.33% sensitivity). Anti- H. pylori IgG and PG assessment (ABC method) was performed (group B, 2.0%; group A, 92.1%). The new cut-off more accurately identified patients with metaplasia requiring follow-up (group B, 5.4%). Assessment of anti- H. pylori IgG and PG is valuable in countries with a low prevalence of H. pylori infection.
Databáze: MEDLINE
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