Prediction of true Helicobacter pylori-uninfected status using a combination of age, serum antibody and pepsinogen: Logistic regression analysis

• Published in: PLoS ONE Vol. 15; no. 10; p. e0240040
• Main Authors: Takayama, Takako, Suzuki, Hideo, Okada, Kosuke, Yamada, Takeshi, Maruo, Kazushi, Saito, Yoko, Mizokami, Yuji
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science (PLoS) 01.10.2020; Public Library of Science
• Subjects: Age; Antibodies; Antigens; Biology and Life Sciences; Classification; Demographic aspects; Diagnosis; Endoscopy; Gastric cancer; Gastritis; Gastroenterology; Helicobacter infections; Helicobacter pylori; Hospitals; Immunoassay; Infections; Latex; Logistic regression; Mathematical models; Medical research; Medicine; Medicine and Health Sciences; Parameter sensitivity; Pepsinogen; Physical Sciences; Physiological aspects; Predictions; Preventive medicine; Regression analysis; Research and Analysis Methods; Science; Sensitivity; Statistical analysis; Stomach cancer; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0240040

To prevent gastric cancer, it is important to accurately determine the presence of Helicobacter pylori (HP) infection. However, correctly identifying HP-uninfected individuals is difficult when using the combination of HP antibody and pepsinogen (PG). The aim of this study was to discriminate true HP-uninfected individuals from others without the need for endoscopic examination. A total of 684 subjects with no history of HP eradication who underwent a medical checkup at our hospital were enrolled. The "true uninfected individuals" were determined by a negative stool antigen test and no endoscopic findings of HP-associated gastritis. HP antibody was measured by the latex immunoassay method. Logistic regression analysis using a combination of noninvasive parameters was performed to develop a formula for predicting true uninfected individuals. A total of 528 subjects were classified as true uninfected individuals. Logistic regression analysis showed that statistically significant factors for true uninfected individuals were age (p < 0.001), HP antibody (p <0.001), PGI (p <0.001), and PGII (p = 0.012). The areas under the curve (AUCs) for true uninfected individuals were the highest (0.944) upon applying the prediction formula including four parameters: age, HP antibody, PGI, and PGII. Both the sensitivity and the specificity of the four-parameter prediction formula were higher than those of the traditional three-parameter model using HP antibody, PGI, and PGI/II ratio (sensitivity: 93.2% vs. 86.6% and specificity: 88.5% vs. 82.7%). Our findings suggest that a model with a combination of four noninvasive parameters is useful for predicting true HP-uninfected individuals without the need for endoscopic examination.