EVALUATION OFHELICOBACTERPYLORI STOOLANTIGEN (HPSA) AND ITSROLE IN DIAGNOSIS ANDFOLLOWUPOF ERADICATION
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With the discovery ofHelicobacterpylori in 1983 byMarshall andWar ren, considerable interest has been expressed in relation to its role in many gastroduodenal and extra-gastric disease. H. pylori is commonly associatedwith gastric and duodenal ulcer. Recnet studies suggest that itplays an important cofactor in the development ofgastric adenocarcinoma andprimary antral B-cell lymphoma. Complete regression ofthese lesions has been documentedfollowing eradication of H. pylori by antibiotic therapy. Prior to the fist description of the 13>14C urea breath test (13I14CUBT), the diagnosis ofH. pylori infection had usually been established by histology, culture, or biopsy, or non-invasively by serology. Although 14C/urea breath test is a simple, practical and highly accu rate non invasive but needs special laboratory and special technicians in addition to its high cost. Detection ofH. pylori by serology reflects only previous exposure toH. pylori andmay not indicate active or recurrent infection. In addition, be cause antibody titers can take up to six months to fall after successfil treatment, serology tests can not readily be used to assess theefficacy of new treatment regimens. In this study, we used two different diagnostic modalities, histopathological examination and Helicobacter Pylori StoolAntigen (HPSA) to detect H. pylori in patients before and after treatment. The main task of this work is assessment ofHPSA as a diagnostic tool before and after treat ment ofH. pylori infection. We studied 30patientswith uppergastro intestinal symptoms as nau-sea, uomittng, fullness, epigastric pain, heart bumand haematemesis, Complete clinical examination, laboratory investigations, ultrasonography and upper gastrointestinal endoscopy with biopsies takenfromdifferent sites ofstomach and stool specimensfor HPSA were done to allpatients. Re-endoscopy and biopsies togetherwithHPSA were donefor cases with H. pylori after one monthfromtherapy. Our results revealed that there is no significant difference in preva lence ofH. pylori as regards age&sexofthepatients. Validation characteristics of the HPSA were good where the values were as follows; sensitivity: 84.2%, specificity: 81.8%, accuracy: 83.3% positivepredicttvity: 88.9% and negativepredictivity 75%.Hence, the results ofthis study are supporting the concept thatHPSA is a simple, accurate and non invasive testfor detection ofH. pylori infection and monitoring the eradication ofH. pylori infection after treatment.