Comparative Study for the Accuracy of Helicobacter pylori Diagnostic Methods Associated with Some Inflammatory Factors

Abstract

This Study was intended to diagnose H. pyiori the major causative pathogen in gastro duodenal irritation and ulceration. Differert techniques were used invasive tests (histopathological examina-tion, rapid urea CLO test and culture) , while noninvasive tests includes (serological tests and stool antigen) in addition to determination of some immune response factors (IgM , IgG , IgA) as well as (IL – 8 and IFN – y) in Ptients Sera. According to the results of invasive diagnostic method 30/113 (26.69%) patients were considered to be infected and 83/113(73.31%) patients were considered as noninfeted was contrasted with noninvasive diagnostic method 25/113 (22.14%) patients were considered to be infected and 88/133(77.83%) patients were considered as noninfeted. In order to get the overall percentage of the infected people included in this study, we merge the results of the two methods ,so we found out that the total infected patients with H. pylori diagnosed by invasive and noninvasive methods were 42 /113 (37.2%) while the noninfected 71/113 (62.8) disseminated as 27/68(39.71%) infect-ed male ,which was privileged than the infected female when it was 15/45(33.33%). The high prevalence of H. pylori infection in the age group ranging between (46-60) in male and female. Histology (invasive teq.) and ECO rapid test (noninvasive teq.) were considered as the ‘‘best techniques ’’ for H. pylori detection, in the outlook of its high specificity, sensitivity and because it detected the major number of H. pylori-positive patients along with the other techniques used in this work. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) for histology were 100,100,100 and 94.5% , respectively, while for the ECO rapid test they were 96, 93, 91.5, and 97.14%. Culture (invasive teq.) and IgG anti H. pylori (noninvasive teq.) coming secondly in the diagnosis of H. pylori infection because they detected a little fewer number of infected patients than the first two teq. as noted above. The sensitivity, specificity, (PPV) (NPV) for Culture were 80%, 97% ,96.96% and87.5% and for IgG anti H. pylori were 85%, 91%,92.8% and 97.8%. Finally the smallest patient number was obtained from the rest of all the six teq. were used in the present work obtained from the urea CLO test and stool antigen, in-vasive and noninvasive teq. respectively. The present research found out that there were a relationship between the results of rapid anti H. pylori ECO test, antibody titer in ELFA, immunoglobulin (IgG and IgA) and (IFN-γ) , (IL-8) concentration. Also, all these data were related to the results of the histological changes and the results of the urea CLO test of patients when compared with the noninfected members. These results showed highly significant differences among patient groups in comparison with noninfect-ed group at (P. Value < 0.001). On the other hand, there were no relationship between IgM con-centration with any of the other results of diagnostic methods were used may such results consid-ered a first step for determining the susceptibility of infection and to confirame the diagnosis by use one more test in each time especialy Histology (invasive teq.) and ECO rapid test (noninva-sive teq.) correlated with estimation of (IgG and IgA) and (IFN-γ), (IL-8) concentration

Keywords

• Helicobacter pylori, Gastric ulcer, Invasive test, noninvasive test, immunological parameters