Pepsinogen and serum igg detection is a valuable diagnostic method for helicobacter pylori infection in a low-prevalence country: A report from Sri Lanka

Dalla Doohan, Kartika Afrida Fauzia, Jeewantha Rathnayake, Meegahalande Durage Lamawansa, Langgeng Agung Waskito, Vo Phuoc Tuan, Azzaya Dashdorj, Evariste Tshibangu Kabamba, Bui Hoang Phuc, Shamshul Ansari, Junko Akada, Takashi Matsumoto, Tomohisa Uchida, Takeshi Matsuhisa, Yoshio Yamaoka

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6 Citations (SciVal)

Abstract

The use of serum anti-Helicobacter pylori IgG and pepsinogen (PG) detection as a diagnostic method was evaluated in Sri Lanka. Gastric biopsies were performed (353 patients), and the prevalence of H. pylori infection was 1.7% (culture) and 2.0% (histology). IgG serology testing showed an area under the curve (AUC) of 0.922 (cut-off, 2.95 U/mL; specificity, 91.56%; sensitivity, 88.89%). Histological evaluation showed mild atrophy (34.3%), moderate atrophy (1.7%), metaplasia (1.7%), chronic gastritis (6.2%), and normal tissue (56%). The PGI/PGII ratio was significantly higher in H. pylori-negative patients (p < 0.01). PGII and PGI/PGII levels were lower in patients with metaplasia than in those with normal mucosa (p = 0.049 and p < 0.001, respectively). The PGI/PGII ratio best discriminated metaplasia and moderate atrophy (AUC 0.88 and 0.76, respectively). PGI and PGII alone showed poor discriminative ability, especially in mild atrophy (0.55 and 0.53, respectively) and chronic gastritis (0.55 and 0.53, respectively). The best cut-off to discriminate metaplasia was 3.25 U/mL (95.19% specificity, 83.33% sensitivity). Anti-H. pylori IgG and PG assessment (ABC method) was performed (group B, 2.0%; group A, 92.1%). The new cut-off more accurately identified patients with metaplasia requiring follow-up (group B, 5.4%). Assessment of anti-H. pylori IgG and PG is valuable in countries with a low prevalence of H. pylori infection.

Original languageEnglish
Article number1364
JournalDiagnostics
Volume11
Issue number8
DOIs
Publication statusPublished - Aug 2021

Keywords

  • Anti-Hp IgG
  • Gastroduodenal diseases
  • Helicobacter pylori
  • Infectious disease
  • Pepsinogen
  • Prevalence
  • Sri Lanka

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