Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori Infection

Infection with Helicobacter pylori has been established as an important risk factor for the development of peptic ulcer disease, gastritis and gastric cancer. The diagnosis of H pylori infection can be established by invasive or noninvasive techniques. Two noninvasive enzyme immunoassays (EIAs) for...

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Main Authors: John M Embil, Shurjeel H Choudhri, Gerry Smart, Thomas Aldor, Norman M Pettigrew, Gordon R Grahame, Magdy R Dawood, Charles N Bernstein
Format: Article
Language:English
Published: Wiley 1998-01-01
Series:Canadian Journal of Infectious Diseases
Online Access:http://dx.doi.org/10.1155/1998/250956
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author John M Embil
Shurjeel H Choudhri
Gerry Smart
Thomas Aldor
Norman M Pettigrew
Gordon R Grahame
Magdy R Dawood
Charles N Bernstein
author_facet John M Embil
Shurjeel H Choudhri
Gerry Smart
Thomas Aldor
Norman M Pettigrew
Gordon R Grahame
Magdy R Dawood
Charles N Bernstein
author_sort John M Embil
collection DOAJ
description Infection with Helicobacter pylori has been established as an important risk factor for the development of peptic ulcer disease, gastritis and gastric cancer. The diagnosis of H pylori infection can be established by invasive or noninvasive techniques. Two noninvasive enzyme immunoassays (EIAs) for antibody detection – HeliSal and Pylori Stat – were compared with histology. Both assays detect immunoglobulin (Ig) G directed against purified H pylori antigen. The test populations consisted of 104 consecutive patients scheduled for upper gastrointestinal endoscopy. Of these patients, 97 (93%) had symptoms compatible with peptic ulcer disease. Saliva and serum were collected simultaneously at the time of endoscopy. Salivary EIA had a sensitivity of 66%, specificity of 67%, positive predictive value of 67% and negative predictive value of 66% compared with the serum EIA, where the results were 98%, 48%, 64% and 96%, respectively. Although the salivary EIA is an appealing noninvasive test, it was not a sensitive and specific assay. The serum EIA also lacked specificity, but was highly sensitive with a good negative predictive value. Although a negative serum EIA rules out H pylori infection, a positive result must be interpreted in the clinical context and confirmed with a more specific measure.
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issn 1180-2332
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spelling doaj-art-65ff67b808624b0abfbd7fc4b51144462025-08-20T03:34:17ZengWileyCanadian Journal of Infectious Diseases1180-23321998-01-019527728010.1155/1998/250956Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori InfectionJohn M Embil0Shurjeel H Choudhri1Gerry Smart2Thomas Aldor3Norman M Pettigrew4Gordon R Grahame5Magdy R Dawood6Charles N Bernstein7Department of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaCadham Provincial Laboratory, Winnipeg, Manitoba, CanadaDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Pathology, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Pathology, University of Manitoba, Winnipeg, Manitoba, CanadaCadham Provincial Laboratory, Winnipeg, Manitoba, CanadaDepartment of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaInfection with Helicobacter pylori has been established as an important risk factor for the development of peptic ulcer disease, gastritis and gastric cancer. The diagnosis of H pylori infection can be established by invasive or noninvasive techniques. Two noninvasive enzyme immunoassays (EIAs) for antibody detection – HeliSal and Pylori Stat – were compared with histology. Both assays detect immunoglobulin (Ig) G directed against purified H pylori antigen. The test populations consisted of 104 consecutive patients scheduled for upper gastrointestinal endoscopy. Of these patients, 97 (93%) had symptoms compatible with peptic ulcer disease. Saliva and serum were collected simultaneously at the time of endoscopy. Salivary EIA had a sensitivity of 66%, specificity of 67%, positive predictive value of 67% and negative predictive value of 66% compared with the serum EIA, where the results were 98%, 48%, 64% and 96%, respectively. Although the salivary EIA is an appealing noninvasive test, it was not a sensitive and specific assay. The serum EIA also lacked specificity, but was highly sensitive with a good negative predictive value. Although a negative serum EIA rules out H pylori infection, a positive result must be interpreted in the clinical context and confirmed with a more specific measure.http://dx.doi.org/10.1155/1998/250956
spellingShingle John M Embil
Shurjeel H Choudhri
Gerry Smart
Thomas Aldor
Norman M Pettigrew
Gordon R Grahame
Magdy R Dawood
Charles N Bernstein
Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori Infection
Canadian Journal of Infectious Diseases
title Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori Infection
title_full Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori Infection
title_fullStr Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori Infection
title_full_unstemmed Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori Infection
title_short Comparison of Salivary and Serum Enzyme Immunoassays for the Diagnosis of Helicobacter pylori Infection
title_sort comparison of salivary and serum enzyme immunoassays for the diagnosis of helicobacter pylori infection
url http://dx.doi.org/10.1155/1998/250956
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