EVALUATION OF HELICOBACTER PYLORI STOOL ANTIGEN (HPSA) AND ITS ROLE IN DIAGNOSIS AND FOLLOW UP OF ERADICATION
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With the discovery of Helicobacter With the discovery of Helicobacter pylori in 1983 by Marshall and Warren. considerable interest has been expressed in relation to its role in many gastroduodenal and extra-gastric disease. H. pylori is commonly associated with gastric and duodenal ulcer. Recnet studies suggest that it plays an important cofactor in the development of gastric adenocarcinoma and primary antral B-cell lymphoma Complete regression of these lesions has been documented following eradication of H. pylori by antibiotic therapy. Prior to the first description of the 13/14C urea breath test (13/14CUM), the diagnosis of H. 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 accurate non invasive but needs special laboratory and special technicians in addition to its high cost. Detection of H. pylori by serology reflects only previous exposure to H. pylori and may not indicate active or recurrent infection. In addition, because antibody titers can take up to six months to fall after successful treatment, serology tests cart not readily be used to assess the efficacy of new treatment regimens. In this study, we used two different diagnostic modalities, histopathological examination and Helicobacter Pylori Stool Antigen (HPSA) to detect H. pylori in patients before and after treatment. The main task of this work is assessment of HPSA as a diagnostic tool before and after treatment of H. pylori infection. We studied 30 patients with upper gastro intestinal symptoms as nau- 977 Roushdilf Allah and Mahmoud El-Azoni sea, vomiting, fullness, epigastric pain, heart burn and haematemesis. Complete clinical examination. laboratory investigations. ultrasonography and upper gastrointestinal endoscopy with biopsies taken from different sites of stomach and stool specimens for HPSA were done to all patients. Re-endoscopy and biopsies together with HPSA were done for cases with H. pylori after one month from therapy. Our results revealed that there Is no significant difference in prevalence of H. pylori as regards age & sex of the patients. Validation characteristics of the HPSA were good where the values were as follows; sensitivity: 84.296, specificity: 81.8%, accuracy: 83.3% positive predictivity: 88.996 and negative predictivity 75%. Hence, the results of this study are supporting the concept that HPSA is a simple, accurate and non invasive test for detection of H. pylori infection and monitoring the eradication of H. pylori infection after treatment.