Current Helicobacter pylori Diagnostics

Abstract

The high prevalence of Helicobacter pylori and the variety of gastroduodenal diseases caused by this pathogen necessitate the use of only accurate methods both for the primary diagnosis and for monitoring the eradication effectiveness. There is a broad spectrum of diagnostic methods available for detecting H. pylori. All methods can be classified as invasive or non-invasive. The need for upper endoscopy, different clinical circumstances, sensitivity and specificity, and accessibility defines the method chosen. This article reviews the advantages and disadvantages of the current options and novel developments in diagnostic tests for H. pylori detection. The progress in endoscopic modalities has made it possible not only to diagnose precancerous lesions and early gastric cancer but also to predict H. pylori infection in real time. The contribution of novel endoscopic evaluation technologies in the diagnosis of H. pylori such as visual endoscopy using blue laser imaging (BLI), linked color imaging (LCI), and magnifying endoscopy is discussed. Recent studies have demonstrated the capability of artificial intelligence to predict H. pylori status based on endoscopic images. Non-invasive diagnostic tests such as the urea breathing test and stool antigen test are recommended for primary diagnosis of H. pylori infection. Serology can be used for initial screening and epidemiological studies. The histology showed its value in detecting H. pylori and provided more information about the degree of gastric mucosa inflammation and precancerous lesions. Molecular methods are mainly used in detecting antibiotic resistance of H. pylori. Cultures from gastric biopsies are the gold standard and recommended for antibiotic susceptibility tests.

Clinical Evaluation of a Novel Stool Antigen Test Using Bioluminescent Enzyme Immunoassay for Detecting Helicobacter pylori

“…Many studies were conducted on the performance evaluations of SAT kits [ 23 – 27 ], but this is the first study that simultaneously evaluated six types of SAT kits. EIA provides more reliable results than ICA [ 28 ]. In the present study, B (EIA) was considered to have better sensitivity than the EIA and IC method for H. pylori antigen.…”

Rapid and Sensitive Assay of Helicobacter pylori With One-Tube RPA-CRISPR/Cas12 by Portable Array Detector for Visible Analysis of Thermostatic Nucleic Acid Amplification

“…For pathogen detection, the introduction of a comfortable self-collection method could help reduce the risk of cross-contamination and increase patient acceptance. In addition to gastric biopsy tissue samples, H. pylori can also be taken from some less invasive methods such as stool, oral saliva, or oral dental plaque ( Bordin et al, 2021 ). Among these less invasive methods, saliva has clear advantages for collection and subsequent processing.…”

Rapid Urease Test vs Histopathological Examination: A Prospective Study to Compare the Accuracy of Both Tests in the Diagnosis of Helicobacter pylori

“…The sensitivity of the histology test ranges from 50% to 95% and depends on the quality, location, size and frequency of the biopsy and the applied staining varieties [18].…”

“…According to Bordin et al [18], the urea breath test is a "gold standard" in the diagnosis of H. pylori infection. The sensitivity and specificity of RUT were 85-95% and 95-100% respectively when compared to the urea breath test.…”

“…False-negative test results are more common than false-positive test results, so a negative result cannot be used to exclude a diagnosis of H. pylori. Thus, a positive RUT result indicates the presence of H. pylori and makes it possible to prescribe treatment, but a negative result does not allow excluding H. pylori [18].…”