Implications of Helicobacter pylori serological titer for the histological severity of antral gastritis.
OBJECTIVE
We attempted to determine whether the serological titer of anti-Helicobacter pylori (HP) immunoglobulin (IgG) would be capable of predicting the presence of ulcer, or would correlate with the histological grading of gastritis in patients with dyspepsia.


METHODS
One hundred eighty-three dyspeptic patients were prospectively included in the study after panendoscopy. Each patient underwent blood sampling for anti-HP IgG titer, and antral biopsy for both a rapid urease test (CLO) and histology. The severity of antral gastritis was semi-quantitated for acute and chronic inflammation scores (range 0-3).


RESULTS
The HP findings were positive in 157 patients (85.5%), and their histological inflammation scores and serological titer were higher than those of HP-negative patients (P < 0.05). Based on the endoscopic findings, these 157 patients were classified into ulcer (n = 109) and non-ulcer dyspepsia (n = 48) subgroups. The mean chronic inflammation score in the ulcer subgroup was higher than that in the non-ulcer dyspepsia subgroup (1.77 vs. 1.28, P < 0.001). However, on the basis of only the titer itself, there was no cut-off value for serological titer to predict the presence or absence of ulcer in HP-infected patients. As the scores for either acute or chronic inflammation increased, the mean serological titer rose (acute inflammation score 0-3: 0.63, 0.78, 0.93, 1.39; chronic inflammation score 0-3: 0.18, 0.56, 0.88, 0.91).


CONCLUSIONS
The titer of HP serology does not provide a method for predicting the presence of ulcer in patients with HP infection, but may indirectly offer evidence of the severity of histological changes.
Sheu
B S
BS
Dept. of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
Shiesh
S C
SC
Yang
H B
HB
Su
I J
IJ
Chen
C Y
CY
Lin
X Z
XZ
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000382:microbiology / Q000473:pathology; D004415:Dyspepsia / Q000382:microbiology / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D004797:Enzyme-Linked Immunosorbent Assay; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005756:Gastritis / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D013276:Stomach Ulcer / Q000382:microbiology / Q000473:pathology
D000907:Antibodies, Bacterial