title: IS THE IMMUNOCROMATOGRAPHIC FECAL ANTIGEN TEST EFFECTIVE FOR PRIMARY DIAGNOSIS OF HELICOBACTER PYLORI INFECTION IN DYSPEPTIC PATIENTS?
abstract: BACKGROUND
  The diagnosis of H. pylori infection can be performed by non-invasive and invasive methods.The identification through a fecal antigen test is a non-invasive, simple, and relatively inexpensive test.
  
  
  OBJECTIVE
  To determine the diagnostic performance of fecal antigen test in the identification of H. pylori infection.
  
  
  METHODS
  H. pylori antigens were identified in the stools of dyspeptic patients undergoing upper gastrointestinal endoscopy. For the identification of H. pylori antigen, we use ImmunoCard STAT! HpSA with immunochromatography technique. Histopathology plus urease test were the gold standard.
  
  
  RESULTS
  We studied 163 patients, 51% male, mean age of 56.7± 8.5years. H. pylori infection was present in 49%. Fecal test presented: sensitivity 67.5% (CI95% 60.6-72.9); specificity 85.5% (CI95% 78.9-90.7); positive predictive value 81.8% (CI95% 73.4-88.4) and negative predictive value 73,2% (CI95% 67.5-77.6); Positive likelihood ratio was 4.7 (CI95% 2.9-7.9) and Negative Likelihood Ratio 0.4 (CI95% 0.3-0.5). The prevalence odds ratio for a positive test was 12.3 (CI95% 5.7-26.3).The index kappa between FAT and histology/urease test was 0.53 (CI95% 0.39-0.64).
  
  
  CONCLUSIONS
  Immunochromatographic FAT is less expensive than the other methods and readily accepted by the patients but its diagnostic performance does not recommend its use in the primary diagnosis, when the patient may have an active infection.
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Santa Maria, RS, Brasil.
authors.forename: Magali
authors.initials: M
authors.lastname: Dalla Nora
authors.affiliation: Laboratório de Microbiologia, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Santa Maria, RS, Brasil.
authors.forename: Rosmari
authors.initials: R
authors.lastname: Hörner
authors.affiliation: Serviço de Gastroenterologia do Hospital Universitário, Universidade Federal de Santa Maria, RS, Brasil.
authors.forename: Diego Michelon
authors.initials: DM
authors.lastname: De Carli
authors.affiliation: Serviço de Patologia do Hospital Universitário, Universidade Federal de Santa Maria, RS, Brasil.
authors.forename: Marta Pires da
authors.initials: MP
authors.lastname: Rocha
authors.affiliation: Departamento de Clínica Médica, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil.
authors.forename: Amanda Faria de
authors.initials: AF
authors.lastname: Araujo
authors.affiliation: Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Santa Maria, RS, Brasil.|Departamento de Clínica Médica, Centro de Ciências da Saúde, Universidade Federal de Santa Maria, Santa Maria, RS, Brasil.
authors.forename: Renato Borges
authors.initials: RB
authors.lastname: Fagundes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000032:analysis*; D001706:Biopsy; D002846:Chromatography, Affinity; D004724:Endoscopy; D005243:Feces / Q000737:chemistry / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial