Blecker U, Lanciers S, Hauser B, Mehta D I, Vandenplas Y
Department of Pediatric, Vrije Universiteit Brussel, Belgium.
Arch Pathol Lab Med. 1995 Jan;119(1):30-2.
Serologic testing is generally accepted as a valid noninvasive screening method for the detection of a Helicobacter pylori infection. To validate serology as an appropriate screening test for H pylori infection in symptom-free subjects, a recent-generation enzyme-linked immunosorbent assay for the detection of H pylori-specific IgG was performed in a large series of asymptomatic women. Blood samples for H pylori serology were taken from 542 apparently healthy women (aged 20 to 40 years) during prenatal screening. In this group, 120 (22.1%) had a positive titer for H pylori. We observed a significantly higher overall prevalence of H pylori seropositivity in nonwhites (62.3%) when compared with Belgian-born whites (17.8%). In both groups there was a significant increase in seropositivity with increasing age. To investigate the correlation between a positive enzyme-linked immunosorbent assay and the actual presence of an active H pylori infection, carbon 13-labeled urea breath tests were performed in 85 seropositive and in 65 randomly selected seronegative subjects. These breath tests were positive in 82 (96.5%) of 85 seropositive and in none of the seronegative subjects, reflecting an actual presence of H pylori in the gastric mucosa of the seropositive women. We conclude that in our population of H pylori-seropositive subjects positive serologic findings correlates extremely well with an active infection with this bacterium. However, because all subjects who were investigated were actually symptom-free, it still should be determined whether these patients should undergo upper gastrointestinal endoscopy and/or be treated with an eradication therapy against H pylori. Further long-term follow-up studies will be required to answer this question.
血清学检测通常被认为是检测幽门螺杆菌感染的一种有效的非侵入性筛查方法。为了验证血清学作为无症状受试者幽门螺杆菌感染的合适筛查试验，我们对一大群无症状女性进行了新一代酶联免疫吸附试验以检测幽门螺杆菌特异性IgG。在产前筛查期间，从542名明显健康的女性（年龄在20至40岁之间）采集了用于幽门螺杆菌血清学检测的血样。在该组中，120名（22.1%）幽门螺杆菌滴度呈阳性。我们观察到，与比利时出生的白人（17.8%）相比，非白人中幽门螺杆菌血清阳性的总体患病率显著更高（62.3%）。在两组中，血清阳性率均随年龄增长而显著增加。为了研究酶联免疫吸附试验阳性与活动性幽门螺杆菌感染实际存在之间的相关性，我们对其中85名血清阳性和65名随机选择的血清阴性受试者进行了碳-13标记尿素呼气试验。这些呼气试验在85名血清阳性受试者中的82名（96.5%）呈阳性，而在血清阴性受试者中均为阴性，这反映了血清阳性女性胃黏膜中实际存在幽门螺杆菌。我们得出结论，在我们的幽门螺杆菌血清阳性受试者群体中，阳性血清学结果与该细菌的活动性感染高度相关。然而，由于所有接受调查的受试者实际上均无症状，仍需确定这些患者是否应接受上消化道内镜检查和/或接受抗幽门螺杆菌根除治疗。需要进一步的长期随访研究来回答这个问题。
