Retrospective Evaluation of Patients with Positive Helicobacter pylori Antigen Test in Stool Samples Together with Pathology Findings

Year 2023, Volume: 1 Issue: 2, 26 - 29, 22.06.2023

Sibel Gülseroğlu , Nisel Yılmaz , Duygu Tekin , Birsen Gizem Özamrak , Esra Canan Kelten Talu

Abstract

Aim: Helicobacter pylori (H. pylori) is a bacterium associated with gastric adenocarcinoma and MALT lymphoma, which causes peptic and chronic ulcer disease in the gastric mucosa in humans. There are non invasive and invasive tests for the diagnosis of H. pylori infection. Among these tests, endoscopic biopsy is the gold standard. In our study, we aimed to compare the specificity and sensitivity of stool
antigen test used for the diagnosis of H. pylori with gastric endoscopic biopsy.

Material and Method: A total of 2270 patients who applied to Health Sciences University Tepecik Training and Research Hospital from various polyclinics among May 2021 and May 2022 with dyspeptic complaints and requested stool antigen test were screened retrospectively. 222 patients who underwent simultaneous stool antigen and endoscopic biopsy for the diagnosis of H. pylori were included in the
study.

Results: While endoscopic biopsy was positive in 46 (70.8%) of 65 patients with positive H. pylori antigen test in stool; H. pylori was positive in endoscopic biopsy in 36 (23%) of 157 patients with negative H. pylori antigen test in stool. Compared with endoscopic biopsy, fecal H. pylori antigen test had a sensitivity of 70.6%, a specificity of 77.1%, a positive predictive value of 70.3%, and a negative predictive value of
77.1%.

Conclusion: When the patients with positive H. pylori antigen test in their stool samples are evaluated together with the pathology findings, the sensitivity and specificity values of the stool antigen diagnostic test are lower than the biopsy.

Dışkı Örneklerinde Helicobacter pylori Antijen Testi Pozitifliği olan Hastaların Patoloji Bulguları ile Beraber Retrospektif Olarak Değerlendirilmesi

Abstract

Amaç: Helicobacter pylori (H. pylori), insan gastrik mukozasında peptik ve kronik ülser hastalığına sebep olan mide adenokarsinomu ve MALT lenfoma ile ilişkili bir bakteridir. H. pylori enfeksiyonun tanısı için invaziv olan ve olmayan testler bulunmaktadır. Yapılan testler arasında endoskopik biyopsi altın standarttır. Çalışmamızda H. pylori tanısı için kullanılan dışkı antijen testinin özgüllük ve duyarlılığının mide endoskopik biyopsisiyle karşılaştırılması amaçlanmıştır.

Gereç ve Yöntem: Sağlık Bilimleri Üniversitesi Tepecik Eğitim ve Araştırma Hastanesi’ne Mayıs 2021- Mayıs 2022 tarihleri arasında çeşitli polikliniklerden gelen dispeptik şikayetler ile başvuran ve dışkı antijen testi istenen toplam 2270 hasta retrospektif olarak taranmıştır. H. pylori tanısı için eşzamanlı dışkıda antijen testi ve endoskopik biyopsi uygulanan 222 hasta çalışmaya dâhil edilmiştir.

Bulgular: Dışkıda H. pylori antijen testi pozitif saptanan 65 hastanın 46 (%70,8)’sında endoskopik biyopsi pozitif iken, dışkıda H. pylori antijen testi negatif saptanan 157 hastanın 36 (%23)’sında endoskopik biyopsi sonucu H. pylori pozitif olarak değerlendirilmiştir. Endoskopik biyopsi ile dışkıda H. pylori antijen testinin karşılaştırılmasında duyarlılık %70,6, özgüllük %77,1, pozitif prediktif değer %70,3, negatif prediktif değer %77,1 olarak bulunmuştur.

Sonuç: Dışkı örneklerinde H. pylori antijen testi pozitifliği olan hastaların patoloji bulguları ile birlikte retrospektif olarak değerlendirilmesinde dışkıda antijen tanı testinin duyarlılık ve özgüllük değerleri biyopsiye oranla düşük görülmektedir.

Keywords

dışkı antijen testi, dispepsi, endoskopi, helicobacter pylori

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