Correlation between Gastric mucosal histology and Faecal antigen test for the detection of Helicobacter pylori infection among dyspeptic patients in a tertiary hospital in south-west Nigeria.


Background and objectives: Dyspepsia is a term used to describe upper abdominal pain or discomfort often associated with eating, early satiety, postprandial abdominal bloating or distention, and nausea. Many of these patients are infected with Helicobacter pylori. A simple method of diagnosis becomes imperative, to reduce the burden on endoscopy services. This study was aimed at determining the correlation between faecal antigen test and gastric mucosal histology in the diagnosis of Helicobacter pylori infection amongst patients undergoing upper gastrointestinal endoscopy.

Methods: A cross-sectional study of consecutive, consenting patients with dyspepsia presenting for upper gastrointestinal endoscopy. Fresh stool samples (rectal smears) were obtained from patients for Helicobacter pylori stool antigen test. Bio-data and results were recorded. Upper gastrointestinal endoscopy was performed using Pentax FG-29W gastroscope with a video monitor and detailed findings noted. Gastric biopsies (3 corpus and 3 antrum) were taken for histological diagnosis of Helicobacter pylori. Data were entered into SPSS (version 20) and analyzed using descriptive and inferential statistics.

Results: There were 150 patients comprising 61(40.7%) males and 89 (59.3%) females. The mean age (±SD) was 45.5 (±14.7) years with a range of 18 – 79 years. Helicobacter pylori was present in 93(62%) of patients on histology, and in 80 (53.3%) of them using Helicobacter pylori Stool Antigen Test (p = 0.000). The sensitivity, specificity, diagnostic accuracy, Positive predictive value, Negative predictive value and Area under the receiver operating characteristic curve for Helicobacter pylori stool antigen test were 79.6%, 89.5%, 83.3%, 92.5, 72.9% and 0.827 respectively. Positive and negative likelihood ratios were 7.58 and 0.228 respectively.

Conclusion: Helicobacter pylori stool antigen test compared favourably with histology and could possibly be used to complement the detection of H. pylori where Urea Breath Test and endoscopy are not available.

Keywords: Faecal antigen test, H. pylori, histology, gastric biopsy, correlation.

Contexte et objectifs: La dyspepsie est un terme utilisé pour décrire les douleurs abdominales supérieures ou les inconvénients souvent associés à la consommation, la satiété précoce, les ballonnements abdominaux postprandial ou la distension et la nausée. Beaucoup de ces patients sont infectés par Helicobacter pylori. Une simple méthode de diagnostic devient impérative, afin de réduire le fardeau des services d’endoscopie. Cette étude visait à déterminer la corrélation entre le test de l’antigène fécal et l’histologie de la muqueuse gastrique dans le diagnostic de l’infection à Helicobacter pylori chez les patients soumis à une endoscopie gastro-intestinale supérieure.

Méthodes: étude transversale de patients consécutifs consentements à la dyspepsie présentant une endoscopie gastro-intestinale supérieure. Des échantillons de selles fraîches (frottis rectaux) ont été obtenus chez des patients pour un test d’antigène des selles Helicobacter pylori. Les données biologiques et les résultats ont été enregistrés. L’endoscopie gastro-intestinale supérieure a été effectuée en utilisant un gastroscope Pentax FG-29W avec un moniteur vidéo et des résultats détaillés constatés. Des biopsies gastriques (3 corpus et 3 antres) ont été prises pour le diagnostic histologique d’Helicobacter pylori. Les données ont été entrées dans SPSS (version 20) et analysées à l’aide de statistiques descriptives et par inférences.

Résultats: 150 patients comptant 61 (40,7%) hommes et 89 (59,3%) des femmes. L’âge moyen (± DE) était de 45,5 (± 14,7) ans avec une étendue de 18 à 79 ans. Helicobacter pylori était présent dans 93 (62%) des patients sur histologie et dans 80 (53,3%) d’entre eux faisant usage du Test Helicobacter pylori Stool Antigen (p = 0,000). La sensibilité, la spécificité, la précision diagnostique, la valeur prédictive  positive, la valeur prédictive négative et la zone sous la courbe caractéristique de fonctionnement du récepteur pour le test antigénique des selles Helicobacter pylori étaient respectivement de 79,6%, 89,5%, 83,3%, 92,5, 72,9% et 0,827. Les rapports de vraisemblance positive et négative étaient respectivement de 7,58 et 0,228.

Conclusion: Le test d’antigène des selles de Helicobacter pylori a été comparé favorablement à l’histologie et pourrait éventuellement être utilisé pour compléter la détection de H. pylori où le test de respiration d’urée et l’endoscopie ne sont pas disponibles.

Mots-clés: Test d’antigène fécal, H. pylori, histologie, biopsie gastrique, corrélation.

Correspondence: Dr. B.I. Umoru, Department of Medicine, Federal Medical Centre, Lokoja, Kogi State, Nigeria. Email:



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