The Diagnostic Value of Non-invasive Tests of the Helicobacter pylori Infection in the Childhood

The infection with Helicobacter pylori, mostly asymptomatic in children, is also an important factor in the development of intestinal metaplasia and gastric carcinoma in adulthood. In the present article we want to establish whether the noninvasive diagnostic tests of the Helicobacter pylori infection could individually and in different combinations be used in every-day paediatric clinical practice. A total of 62 coincidentally chosen children with symp­toms and signs suspicious of the HP infection were prospectively studied. They underwent four noninvasive diagnostic tests: serology – specific antibodies IgA and IgG against HP, stool antigen test and 13-C urea breath test. 32 of the patients had their infection confirmed with the invasive gold standard method. We calculated specificity, sensitivity, positive and nega­tive predictive value and ROC area under the curve for an individual test. We estimated the diagnostic values of test combinations with ROC testing and classic discriminative analysis. Urea breath test compared to HpSA, IgG and IgA has been shown to have the highest diag­nostic value as an individual test. The combination of all four tests has the diagnostic value that is higher than of any of the individual tests. The same applies to combination urea breath test + HpSA or with serology. The results of combination of both serologic tests and combina­tion serology + HpSA turned out to be worse. Urea breath test individually and its combinations with HpSA or serology (IgG, IgA) are clinically applicable as the screening methods for HP infection. The same goes to the combination of all four tests.