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. |
