A combination of serum anti-Helicobacter pylori antibody titer and Kyoto classification score could provide a more accurate diagnosis of H pylori. Issue 3 (April 2019)

• Record Type: Journal Article
• Authors: Nishizawa, Toshihiro; Sakitani, Kosuke; Suzuki, Hidekazu; Yamakawa, Tadahiro; Takahashi, Yoshiyuki; Yamamichi, Nobutake; Watanabe, Hidenobu; Seto, Yasuyuki; Koike, Kazuhiko; Toyoshima, Osamu
• Is Part Of: United European Gastroenterology journal. Volume 7:Issue 3(2019)
• Page Start: 343
• Page End: 348
• Publication Date: 2019-04
• Subjects: Antibody titer -- H pylori -- Kyoto classification score; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640619825947
• Languages: English
• ISSNs: 2050-6406

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.