Comparison of Non-invasive tests with Endoscopic Biopsy in Diagnosis of Helicobacter Pylori Infection in Pediatric Patients

Dr Rakesh Nagar; Dr S.K. Vishnoi; Dr Rakesh Jora; Dr Pramod Sharma

Volume : V, Issue : XII, December - 2016

Comparison of Non-invasive tests with Endoscopic Biopsy in Diagnosis of Helicobacter Pylori Infection in Pediatric Patients

Dr Rakesh Nagar, Dr S. K. Vishnoi, Dr Rakesh Jora, Dr Pramod Sharma

Abstract :

Background & Objective: Helicobacter Pylori is a recognized pathogen for gastritis, acid peptic disease and gastric adeno-carcinomas. Usually acquisition of infection occurs in early childhood. The objective of this study is to comparison invasive tests for diagnosis of H. Pylori infection in comparison with the gold standard test (endoscopic biopsy and histopathology). Method: We have enrolled 100 Pediatric patients presenting with gastro-intestinal symptoms in our study. Endoscopic biopsy with histopathological examination (H & E Staining), stool antigen and serum immunoglobulin G for H. Pylori (non-invasive tests) were performed in all enrolled cases. Sensitivity, specificity, positive predictive value and negative predictive value of these two non-invasive tests separately and in combination (in series) were compared to the gold standard test. Results: 23% patients were positive for H. Pylori infection on histopathology (H & E staining) of biopsy specimen. Stool antigen for H. Pylori had a sensitivity of 91.30% & specificity of 98.70%, a positive predictive value of 95.45% and a negative predictive value of 97.43%. Serum immunoglobulin G H. Pylori was 73.91% sensitive, 97.40% specific and had a positive predictive value of 89.47% and a negative predictive value of 92.59%. Combination (in series) of non-invasive tests revealed a sensitivity of 69.56%, a specificity of 100%, a positive predictive value of 100% and a negative predictive value of 91.66%. Conclusion: Our study has demonstrated that combination of non-invasive test was as efficacious as the gold standard test. Stool antigen for H. Pylori is a simple, suitable and easily applicable in paediatric age patients, proved to be more accurate than serum immunoglobulin for H. Pylori.