Veenendaal R A, Götz J M, Schroijen V, Kurban F, Bernards A T, Veselic M, Peña A S, Lamers C B
Department of Gastroenterology and Hepatology, University Hospital Leiden, The Netherlands.
J Clin Pathol. 1995 Nov;48(11):990-3. doi: 10.1136/jcp.48.11.990.
To investigate the diagnostic value of mucosal IgA and IgG Helicobacter pylori antibodies.
The study population comprised 209 consecutive patients with severe dyspeptic complaints referred for upper gastrointestinal endoscopy. A positive culture or histological identification of H pylori in gastric biopsy specimens, or both, were used to confirm infection. Specific IgA and IgG H pylori antibodies were determined using a modified ELISA technique.
Of the 209 patients, 137 were infected with H pylori. The diagnostic value of systemic IgA and IgG H pylori antibodies was confirmed. Systemic IgA antibodies had a sensitivity of 76.6% (95% confidence interval 69.5-83.7) and a specificity of 94.4% (89.1-99.7). The sensitivity and specificity for systemic IgG antibodies were, respectively, 97.1% (94.3-99.9) and 98.6% (95.9-100). A moderate but clinically important correlation was found between local and systemic IgA and IgG. Mucosal IgA H pylori antibodies had a sensitivity of 98.5% (96.5-100) and a specificity of 91.7% (85.3-98.1), while for IgG these figures were, respectively, 88.3% (82.9-93.7) and 98.6% (95.9-100). As a diagnostic test mucosal IgA H pylori antibodies were comparable with culture and histology.
Determination of local IgA and IgG H pylori antibody levels is a highly sensitive and specific test for the diagnosis of H pylori infection.
探讨黏膜幽门螺杆菌IgA和IgG抗体的诊断价值。
研究对象为209例因严重消化不良症状连续转诊接受上消化道内镜检查的患者。胃活检标本中幽门螺杆菌培养阳性或组织学鉴定阳性，或两者均阳性，用于确诊感染。采用改良ELISA技术测定特异性幽门螺杆菌IgA和IgG抗体。
209例患者中，137例感染幽门螺杆菌。全身幽门螺杆菌IgA和IgG抗体的诊断价值得到证实。全身IgA抗体的敏感性为76.6%（95%置信区间69.5 - 83.7），特异性为94.4%（89.1 - 99.7）。全身IgG抗体的敏感性和特异性分别为97.1%（94.3 - 99.9）和98.6%（95.9 - 100）。发现局部和全身IgA及IgG之间存在中度但具有临床意义的相关性。黏膜幽门螺杆菌IgA抗体的敏感性为98.5%（96.5 - 100），特异性为91.7%（85.3 - 98.1），而IgG的这些数字分别为88.3%（82.9 - 93.7）和98.6%（95.9 - 100）。作为一种诊断试验，黏膜幽门螺杆菌IgA抗体与培养及组织学检查相当。
测定局部幽门螺杆菌IgA和IgG抗体水平是诊断幽门螺杆菌感染的一种高度敏感和特异的试验。
