A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of Helicobacter pylori Infection in Children ()
ABSTRACT
Proper diagnosis in the pediatric population is required to eradicate Helicobacter pylori (H.
pylori) and
prevent gastric cancer. Our aim was to assess the performance of non-invasive
tests to diagnose H.
pylori infection in pediatric patients. A retrospective analysis
was performed on 141 pediatric patients requiring endoscopic evaluation and
diagnostic tests for H.
pylori infection to define the cause of abdominal symptoms.
Non-invasive tests included the 13C-urea breath test (UBT), a
monoclonal stool antigen test using enzyme-linked immuno-sorbent assay (mSAT),
and a serum immunoglobulin G antibody test using antigens derived from Japanese
individuals (S-Ab). This study investigated sensitivity, specificity,
likelihood ratios for a positive and a negative test (LR+ and LR-), and
accuracy of non-invasive tests, in comparison with invasive tests. Eighty two
of 141 patients (58%) were recognized as H.
pylori positive by invasive methods. When UBT, mSAT or S-Ab were
analyzed, all were found to be effective over 94% accurate. Specificity ranged
between 86.7% and 95.8%, and sensitivity ranged between 93.8% and 97.1%. When
subjects were stratified into three distinct age groups, the best performance
was achieved for 1-6
years old with mSAT at 100% for sensitivity, specificity, and accuracy. S-Ab
yielded the best results for children 7-12 years old and the UBT test performed
best for 13-18
years old. These results demonstrate the utility of UBT, mSAT, and S-Ab
non-invasive tests in diagnosing H.
pylori but suggest that certain tests may be optimal for children
of distinct ages. Three non-invasive tests, UBT, mSAT and S-Ab showed
sufficient sensitivity, specificity and accuracy for the initial diagnosis of H. pylori infection
among pediatric patients. Non-invasive tests may contribute to achieving minimum invasive diagnosis with combining
with a histological test and a culture test in children.
Share and Cite:
Ikuse, T. , Kudo, T. , Obayashi, N. , Jimbo, K. , Aoyagi, Y. , Ohtsuka, Y. , Blanchard, T. , Czinn, S. and Shimizu, T. (2017) A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of
Helicobacter pylori Infection in Children.
Advances in Microbiology,
7, 253-264. doi:
10.4236/aim.2017.74021.