联合检测IgG和IgA抗体对幽门螺杆菌感染血清学诊断的实用性。

Usefulness of the combined IgG and IgA antibody determinations for serodiagnosis of Helicobacter pylori infection.

作者信息

Martín-de-Argila C, Boixeda D, Cantón R, Valdezate S, Mir N, De Rafael L, Gisbert J P, Baquero F

机构信息

Department of Gastroenterology, University of Alcalá de Henares, Ramón y Cajal Hospital, Madrid, Spain.

出版信息

Eur J Gastroenterol Hepatol. 1997 Dec;9(12):1191-6.

PMID:9471025

Abstract

BACKGROUND

Serology is a good alternative, minimally invasive, diagnostic and screening test for Helicobacter pylori infection. Several immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) commercial kits have been evaluated. Information on IgA ELISAs is relatively poor, and on the combined use of IgG and IgA ELISAs very scarce.

OBJECTIVE

We intended to evaluate the sensitivity, specificity and predictive values of two quantitative commercial IgG and IgA ELISAs (Helico-G and GAP, respectively) and more particularly the accuracy of their combined use.

PATIENTS AND METHODS

Serum samples and gastric biopsy specimen culture findings from 400 patients were evaluated.

RESULTS

The sensitivity, specificity, positive and negative predictive values of the IgG ELISA Helico-G test in detecting IgG antibodies to H. pylori were 97.2, 85.4, 98.3 and 77.8%, respectively, when compared with those of the reference method used. The corresponding findings for detection of IgA antibodies with the GAP test were 96.4, 80.5, 97.7 and 71.1%, respectively. When considering a patient infected with H. pylori when both tests were positive, the sensitivity, specificity, positive and negative predictive values were 94.1, 85.3, 98.2 and 62.5%, respectively. On the other hand, when at least one test was positive, the corresponding values were 99, 80, 97 and 94%, respectively.

CONCLUSION

The IgG ELISA Helico-G and IgA ELISA GAP, taken separately, are good and reliable tests for the detection of antibodies to H. pylori. Furthermore, the combined use of both serological methods provided more useful information compared with single IgG and IgA determinations.

摘要

背景

血清学检测是一种用于幽门螺杆菌感染的良好替代方法，具有微创性，可用于诊断和筛查。已有多种免疫球蛋白G（IgG）酶联免疫吸附测定（ELISA）商业试剂盒得到评估。关于IgA ELISA的信息相对较少，而关于IgG和IgA ELISA联合使用的信息则非常稀缺。

目的

我们旨在评估两种定量商业IgG和IgA ELISA（分别为Helico-G和GAP）的敏感性、特异性和预测值，尤其关注它们联合使用时的准确性。

患者和方法

对400例患者的血清样本和胃活检标本培养结果进行评估。

结果

与所采用的参考方法相比，IgG ELISA Helico-G检测幽门螺杆菌IgG抗体的敏感性、特异性、阳性预测值和阴性预测值分别为97.2%、85.4%、98.3%和77.8%。使用GAP检测IgA抗体的相应结果分别为96.4%、80.5%、97.7%和71.1%。当两种检测均为阳性时判定患者感染幽门螺杆菌，其敏感性、特异性、阳性预测值和阴性预测值分别为94.1%、85.3%、98.2%和62.5%。另一方面，当至少一项检测为阳性时，相应的值分别为99%、80%、97%和94%。