Accuracy of Helicobacter pylori serology in two peptic ulcer populations and in healthy controls.
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.
Lindsetmo
Rolv-Ole
RO
Department of Gastrointestinal Surgery, University Hospital of North Norway, and Institute of Clinical Medicine, Tromso University, Tromso, Norway. rolv.ole.lindsetmo@unn.no
Johnsen
Roar
R
Eide
Tor Jac
TJ
Gutteberg
Tore
T
Husum
Hanne Haukland
HH
Revhaug
Arthur
A