title: Accuracy of Helicobacter pylori serology in two peptic ulcer populations and in healthy controls.
abstract: OBJECTIVE
  To estimate the test characteristics of Helicobacter pylori (H pylori) serology and of C14-urea breath test (C14-UBT) in two different peptic ulcer populations and in community controls. Second, the aim was to explore the association between the level of H pylori IgG antibodies and severity of inflammation as to active peptic ulceration in the same populations.
  
  
  METHODS
  Vagotomized (n = 83), medically treated peptic ulcer patients (n = 73) and one reference group of community controls (n = 88) were gastroscoped. H pylori status was determined by histology, bacterial growth, C14-UBT and serology. Based on the updated Sydney System, cumulative scores from biopsies from the prepyloruos, incisura angularis, corpus and fundus were calculated.
  
  
  RESULTS
  The prevalence of H pylori infection varied from 70% to 79%. The C14-UBT had high accuracy compared to the serology test. The sensitivity of the serology test was good, but the specificity was low (41%-71%). The association between H pylori IgG antibodies and scores of gastric mucosal inflammation and current or previous peptic ulcer were weak.
  
  
  CONCLUSIONS
  The accuracy of C14-UBT to diagnose H pylori infection was good, and the clinical utility of a negative H pylori serology test was substantial, while the gain in clinical information of a positive test was meagre. Positive H pylori titres could not distinguish between subjects with or those without active peptic ulceration.
authors.affiliation: Department of Gastrointestinal Surgery, University Hospital of North Norway, and Institute of Clinical Medicine, Tromso University, Tromso, Norway. rolv.ole.lindsetmo@unn.no
authors.forename: Rolv-Ole
authors.initials: RO
authors.lastname: Lindsetmo
authors.forename: Roar
authors.initials: R
authors.lastname: Johnsen
authors.forename: Tor Jac
authors.initials: TJ
authors.lastname: Eide
authors.forename: Tore
authors.initials: T
authors.lastname: Gutteberg
authors.forename: Hanne Haukland
authors.initials: HH
authors.lastname: Husum
authors.forename: Arthur
authors.initials: A
authors.lastname: Revhaug