BacteriologyIs GastroPanel serum assay useful in the diagnosis of Helicobacter pylori infection and associated gastritis in children?
Introduction
Histology obtained from endoscopic biopsies has remained the gold standard in the diagnosis of H. pylori-related gastritis. In children, however, endoscopy is an invasive procedure that requires general anesthesia, and other diagnostic means such as breath test and serum and stool samples have been adopted. In children, however, the sensitivity of the less invasive tests has been low, and a biopsy is still needed for the diagnosis of H. pylori (Bourke et al., 2005). In adults, the serum concentrations of pepsinogens I and II (PGI, PGII), gastrin (G17), and H. pylori antibodies of IgG class have been used to assess the risk of atrophic gastritis and to differentiate between H. pylori-related and non–H. pylori-related gastritis (Vaananen et al., 2003). In the present study, we assess the performance of PGI, PGII, G17, and H. pylori antibody determination by GastroPanel kit (Biohit, Helsinki, Finland) in sera by comparing the results with endoscopic biopsies of gastric mucosa. We test the following hypotheses: can endoscopy and biopsies be replaced with GastroPanel assay in children and do the H. pylori-infected children present with markers for atrophic gastritis?
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Materials and methods
Eighty children (median age, 6.8 years; range, 0.6–18.7 years; male, n = 43; Caucasian n = 54, African n = 25, Asian n = 1) underwent endoscopy of the upper gastrointestinal tract with gastric biopsies. Indications for endoscopies are shown in Table 1. Twenty-eight (70%) of the 40 patients whose abdominal pains were suspected to relate with H. pylori had breath (n = 3), blood (n = 23), or stool (n = 14) tests indicative of H. pylori infection. Three patients with abdominal pains had been
Endoscopy and histology
Thirty children (median age, 6.7 years; range, 2.4–12.1 years) had H. pylori-related gastritis (H. pylori-positive) (biopsy- and culture-positive, n = 29; biopsy positive + culture negative, n = 1 ), and in 50 children, H. pylori was not found either in biopsy or culture (H. pylori-negative). Of the 30 H. pylori-positive children, 23 were of African origin (n = 25) and 7 of Caucasian origin (n = 54) (P < 0.05). Of the 50 H. pylori-negative children, 41 (median age, 5.9 years; range, 0.6–17.9)
Discussion
The present study attempted to find out whether GastroPanel assay can provide an accurate diagnosis for H. pylori infection and H. pylori-related gastritis in children by comparing the test results with endoscopic gastric biopsies. We found that in H. pylori-positive children, the mean serum concentrations of HPAB and PGII were significantly higher and PGI/II ratio lower than in those H. pylori-negative. However, HPAB and PGII serum concentrations overlapped between H. pylori-positive and H.
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