Usefulness of a serological panel test in the assessment of gastritis in symptomatic children.
BACKGROUND
Non-invasive methods are advisable for the detection of Helicobacter pylori-related chronic gastritis in pediatric patients. Serum pepsinogens I and II (sPGII and sPGII), gastrin-17 (G-17) and anti-H. pylori antibodies (IgG-Hp) have been proposed as a 'serological gastric biopsy'.


OBJECTIVE
To assess H. pylori infection and to evaluate gastric mucosa status in a pediatric population by means of serological parameters such as sPGI, sPGII, G-17 and IgG-Hp.


METHODS
45 consecutively children evaluated for upper gastrointestinal symptoms were analyzed. All children were submitted to upper gastrointestinal endoscopy with biopsies. Serum samples were analyzed for IgG-Hp, sPGII, sPGI and G-17 (Biohit, Helsinki, Finland).


RESULTS
18 children had H. pylori-related mild or moderate non-atrophic chronic gastritis. They presented significantly higher mean levels of sPGII and of IgG-Hp than negative ones, either under or up to 10 years. sPGI showed significantly increased levels in H. pylori-positive patients only over 10 years. G-17 levels were not different between H. pylori-positive and -negative ones. The best cut-offs of IgG-Hp, sPGII and of product IgG-Hp x sPGII, to identify H. pylori infection, were 30 IU/l, 9 microg/l, and 241 IU/l x microg/l, respectively. The product IgG-Hp x sPGII identified H. pylori infection with a 100% sensitivity, 92% specificity, 90% positive predictive value and 100% negative predictive value. IgG-Hp and IgG-Hp showed a correlation (r = 0.94; p < 0.001).


CONCLUSIONS
Combined analysis of sPGII and IgG-Hp antibody levels could be recommended as a non-invasive panel for the assessment of H. pylori-related histological alterations of gastric mucosa in childhood.
de Angelis
Gian Luigi
GL
Department of Paediatrics, University of Parma, Parma, Italy.
Cavallaro
Lucas Giovanni
LG
Maffini
Valentina
V
Moussa
Ali Mahamat
AM
Fornaroli
Fabiola
F
Liatopoulou
Stefania
S
Bizzarri
Barbara
B
Merli
Roberta
R
Comparato
Giuseppe
G
Caruana
Pietro
P
Cavestro
Giulia Martina
GM
Franzé
Angelo
A
Di Mario
Francesco
F
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005755:Gastrins / Q000097:blood*; D005756:Gastritis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D010435:Pepsinogens / Q000097:blood*