A combination of serum anti-Helicobacter pylori antibody titer and Kyoto classification score could provide a more accurate diagnosis of H pylori

Toshihiro Nishizawa, Kosuke Sakitani, Hidekazu Suzuki, Tadahiro Yamakawa, Yoshiyuki Takahashi, Nobutake Yamamichi, Hidenobu Watanabe, Yasuyuki Seto, Kazuhiko Koike, Osamu Toyoshima

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Abstract

Background: We previously showed that the endoscopic Kyoto classification for gastritis could predict Helicobacter pylori infection in individuals with a high negative titer of serum anti-H pylori antibodies. This study evaluated H pylori infection and the Kyoto classification score in patients with a low negative titer (<3 U/ml), high negative titer (3–9.9 U/ml), low positive titer (10–49.9 U/ml), and high positive titer (≥50 U/ml). Methods: Serum antibody levels, Kyoto classification score and histology were investigated in 870 individuals with no history of H pylori-eradication therapy. Urea breath tests (UBTs) were additionally conducted for patients with a low negative titer and a Kyoto score ≥1 or an antibody titer ≥10 U/ml and a Kyoto score of 0 or 1. UBTs and/or histological studies were conducted for participants with a high negative titer. Results: False diagnoses based on anti-H pylori antibody titers were observed in 0.3% of the low-negative-titer group, 11.7% of the high-negative-titer group, 18.9% of the low-positive-titer group and 2.2% of the high-positive-titer group. Surprisingly, false diagnoses based on antibody titers were noted in 63.2% of patients with a low positive titer and a Kyoto score of 0 and in 62.5% of patients with a high negative titer and a Kyoto score ≥2, respectively. Conclusions: Endoscopic findings could predict false diagnoses determined using serum antibody titers.

Original languageEnglish
JournalUnited European Gastroenterology Journal
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Pylorus
Helicobacter pylori
Antibodies
Serum
Breath Tests
Urea
Helicobacter Infections
Gastritis
Histology
Infection

Keywords

  • Antibody titer
  • H pylori
  • Kyoto classification score

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

A combination of serum anti-Helicobacter pylori antibody titer and Kyoto classification score could provide a more accurate diagnosis of H pylori. / Nishizawa, Toshihiro; Sakitani, Kosuke; Suzuki, Hidekazu; Yamakawa, Tadahiro; Takahashi, Yoshiyuki; Yamamichi, Nobutake; Watanabe, Hidenobu; Seto, Yasuyuki; Koike, Kazuhiko; Toyoshima, Osamu.

In: United European Gastroenterology Journal, 01.01.2019.

Research output: Contribution to journalArticle

Nishizawa, Toshihiro ; Sakitani, Kosuke ; Suzuki, Hidekazu ; Yamakawa, Tadahiro ; Takahashi, Yoshiyuki ; Yamamichi, Nobutake ; Watanabe, Hidenobu ; Seto, Yasuyuki ; Koike, Kazuhiko ; Toyoshima, Osamu. / A combination of serum anti-Helicobacter pylori antibody titer and Kyoto classification score could provide a more accurate diagnosis of H pylori. In: United European Gastroenterology Journal. 2019.
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abstract = "Background: We previously showed that the endoscopic Kyoto classification for gastritis could predict Helicobacter pylori infection in individuals with a high negative titer of serum anti-H pylori antibodies. This study evaluated H pylori infection and the Kyoto classification score in patients with a low negative titer (<3 U/ml), high negative titer (3–9.9 U/ml), low positive titer (10–49.9 U/ml), and high positive titer (≥50 U/ml). Methods: Serum antibody levels, Kyoto classification score and histology were investigated in 870 individuals with no history of H pylori-eradication therapy. Urea breath tests (UBTs) were additionally conducted for patients with a low negative titer and a Kyoto score ≥1 or an antibody titer ≥10 U/ml and a Kyoto score of 0 or 1. UBTs and/or histological studies were conducted for participants with a high negative titer. Results: False diagnoses based on anti-H pylori antibody titers were observed in 0.3{\%} of the low-negative-titer group, 11.7{\%} of the high-negative-titer group, 18.9{\%} of the low-positive-titer group and 2.2{\%} of the high-positive-titer group. Surprisingly, false diagnoses based on antibody titers were noted in 63.2{\%} of patients with a low positive titer and a Kyoto score of 0 and in 62.5{\%} of patients with a high negative titer and a Kyoto score ≥2, respectively. Conclusions: Endoscopic findings could predict false diagnoses determined using serum antibody titers.",
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AU - Sakitani, Kosuke

AU - Suzuki, Hidekazu

AU - Yamakawa, Tadahiro

AU - Takahashi, Yoshiyuki

AU - Yamamichi, Nobutake

AU - Watanabe, Hidenobu

AU - Seto, Yasuyuki

AU - Koike, Kazuhiko

AU - Toyoshima, Osamu

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N2 - Background: We previously showed that the endoscopic Kyoto classification for gastritis could predict Helicobacter pylori infection in individuals with a high negative titer of serum anti-H pylori antibodies. This study evaluated H pylori infection and the Kyoto classification score in patients with a low negative titer (<3 U/ml), high negative titer (3–9.9 U/ml), low positive titer (10–49.9 U/ml), and high positive titer (≥50 U/ml). Methods: Serum antibody levels, Kyoto classification score and histology were investigated in 870 individuals with no history of H pylori-eradication therapy. Urea breath tests (UBTs) were additionally conducted for patients with a low negative titer and a Kyoto score ≥1 or an antibody titer ≥10 U/ml and a Kyoto score of 0 or 1. UBTs and/or histological studies were conducted for participants with a high negative titer. Results: False diagnoses based on anti-H pylori antibody titers were observed in 0.3% of the low-negative-titer group, 11.7% of the high-negative-titer group, 18.9% of the low-positive-titer group and 2.2% of the high-positive-titer group. Surprisingly, false diagnoses based on antibody titers were noted in 63.2% of patients with a low positive titer and a Kyoto score of 0 and in 62.5% of patients with a high negative titer and a Kyoto score ≥2, respectively. Conclusions: Endoscopic findings could predict false diagnoses determined using serum antibody titers.

AB - Background: We previously showed that the endoscopic Kyoto classification for gastritis could predict Helicobacter pylori infection in individuals with a high negative titer of serum anti-H pylori antibodies. This study evaluated H pylori infection and the Kyoto classification score in patients with a low negative titer (<3 U/ml), high negative titer (3–9.9 U/ml), low positive titer (10–49.9 U/ml), and high positive titer (≥50 U/ml). Methods: Serum antibody levels, Kyoto classification score and histology were investigated in 870 individuals with no history of H pylori-eradication therapy. Urea breath tests (UBTs) were additionally conducted for patients with a low negative titer and a Kyoto score ≥1 or an antibody titer ≥10 U/ml and a Kyoto score of 0 or 1. UBTs and/or histological studies were conducted for participants with a high negative titer. Results: False diagnoses based on anti-H pylori antibody titers were observed in 0.3% of the low-negative-titer group, 11.7% of the high-negative-titer group, 18.9% of the low-positive-titer group and 2.2% of the high-positive-titer group. Surprisingly, false diagnoses based on antibody titers were noted in 63.2% of patients with a low positive titer and a Kyoto score of 0 and in 62.5% of patients with a high negative titer and a Kyoto score ≥2, respectively. Conclusions: Endoscopic findings could predict false diagnoses determined using serum antibody titers.

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