Evaluation of two stool antigen tests for the detection of Helicobacter pylori infection in the Chinese population

• Published in: Journal of gastroenterology and hepatology Vol. 18; no. 1; pp. 26 - 31
• Main Authors: WONG, BENJAMIN CHUN YU, XIA, HARRY HUA XIANG, CHEUNG, HESS KWAN LOK, NG, FOOK HONG, WONG, SIU YIN, CHOW, KAI CHIU, LIN, SHAO KAI, YIN, YAN, WONG, WAI MAN, YUEN, MAN FUNG, LAM, SHIU KUM
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Science Pty 01.01.2003; Blackwell Science
• Subjects: Aged; antigen; Antigens, Bacterial - isolation & purification; Asian Continental Ancestry Group; Biological and medical sciences; diagnosis; Feces - microbiology; Female; Helicobacter Infections - diagnosis; Helicobacter Infections - ethnology; Helicobacter pylori; Helicobacter pylori - immunology; Humans; immunoassay; Immunoenzyme Techniques; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Miscellaneous. Technology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Asia; China; Performance evaluation; Human; Spirillales; Spirillaceae; Gastritis; Immunological method; immunoassay; Infection; Antigen; Sensitivity; Specificity; Helicobacter pylori; Bacteriosis; Digestive diseases; Bacteria; Diagnosis; Feces; Technique; Comparative study; Gastric disease
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1046/j.1440-1746.2003.02926.x

Background and Aim: The stool antigen test, the HpSA test, has been validated mainly in Western countries, but not properly in the Chinese population. Recently, another stool antigen test, the Apollo test, was developed, but its accuracy has rarely been validated. The aim of this study is to compare the accuracy of these two tests in the diagnosis of Helicobacter pylori infection in the Chinese population. Methods: Consecutive dyspeptic patients referred for upper endoscopy were recruited. During endoscopy, biopsies were taken for the rapid urease test and histological examination as the gold standard. Stool specimens were collected and used for the HpSA and Apollo tests. Results: Overall, 86 patients (39 males and 47 females, with a mean age of 55.8 years) were recruited. Helicobacter pylori infection was present in 44 (51%) patients as determined by the gold standard. The sensitivity, specificity and accuracy were 86.4, 100, and 93.0%, respectively, for the HpSA, and 90.9, 97.6, and 94.2%, respectively, for the Apollo test when cases with equivocal results were considered as positive. In addition, agreement was achieved in 81 (94.2%) cases between the two tests, with a Kappa value of 0.887. Conclusion: Both the HpSA and Apollo tests achieve acceptable sensitivity and excellent specificity, with accuracies of over 90% for the detection of H. pylori infection in the Chinese population. © 2003 Blackwell Publishing Asia Pty Ltd