Iranikhah Abolfazl, Ghadir Mohammad-Reza, Sarkeshikian Saeed, Saneian Hosein, Heiari Akram, Mahvari Mohadeseh
Department of Pediatric Gastroenterology, Qom University of Medical Sciences, Qom, Iran.
Iran J Pediatr. 2013 Apr;23(2):138-42.
Reliable non-invasive methods for detection of Helicobacter pylori (H. pylori) infection are required to investigate the incidence, transmission, and clearance of infection in childhood. Detecting bacterial antigens in stool offer an alternative noninvasive diagnostic test. However its accuracy in developing countries is not well established. The aim of this study was to evaluate the performance of stool antigen test for H pylori in Iranian children with recurrent abdominal pain necessitating endoscopy.
One hundred three children enrolled in this study. Endoscopy and biopsy was done on all patients providing a criterion standard for validation of the H. pylori stool antigen (HpSA) tests. The presence of H. pylori organisms in stool was determined by an enzyme-linked immunosorbent assay using a commercially available polyclonal antibody. HpSA sensitivity, specificity, and positive and negative likelihood ratios were determined with reference to the results of cultures of gastric biopsy.
Of the 103 children tested 41 (39.8%) and 39 (37.8%) were positive for H. pylori according to the results of cultures of gastric biopsy and HpSA, respectively. The sensitivity, specificity, and positive and negative likelihood ratios of HpSA were found to be 85%, 93%, 89.7%, and 90%, respectively.
In this pilot study, a low-cost and rapid diagnostic technique, stool antigen test proved to be highly sensitive and specific for detecting H pylori infection in children with recurrent abdominal pain. Our results are comparable to those reported elsewhere in children and demonstrate that the HpSA test can replace endoscopy and biopsy for detecting H. pylori infection.
需要可靠的非侵入性方法来检测幽门螺杆菌（H. pylori）感染，以调查儿童期感染的发病率、传播和清除情况。检测粪便中的细菌抗原提供了一种替代性的非侵入性诊断测试。然而，其在发展中国家的准确性尚未得到充分证实。本研究的目的是评估粪便抗原检测对有反复腹痛且需要进行内镜检查的伊朗儿童幽门螺杆菌的检测性能。
103名儿童参与了本研究。对所有患者进行了内镜检查和活检，为验证幽门螺杆菌粪便抗原（HpSA）检测提供了标准对照。使用市售多克隆抗体通过酶联免疫吸附测定法测定粪便中幽门螺杆菌的存在情况。根据胃活检培养结果确定HpSA的敏感性、特异性以及阳性和阴性似然比。
根据胃活检培养结果，103名接受检测的儿童中有41名（39.8%）幽门螺杆菌呈阳性，根据HpSA检测结果，有39名（37.8%）呈阳性。发现HpSA的敏感性、特异性、阳性和阴性似然比分别为85%、93%、89.7%和90%。
在这项初步研究中，粪便抗原检测作为一种低成本且快速的诊断技术，被证明对检测有反复腹痛的儿童幽门螺杆菌感染具有高度敏感性和特异性。我们的结果与其他地方报道的儿童结果相当，表明HpSA检测可以替代内镜检查和活检来检测幽门螺杆菌感染。
