Clinical Utility of Helicobacter pylori Stool Antigen Testing with a Bioluminescent Enzyme Immunoassay Using a Fecal Occult Blood Test Container

Intern Med. 2024 Dec 15;63(24):3271-3275. doi: 10.2169/internalmedicine.3480-24. Epub 2024 May 9.

Abstract

Objective A dedicated stool container is required for Helicobacter pylori stool antigen testing. If H. pylori fecal antigen can be measured from a fecal occult blood test container (S fecal collection container or S container), which is widely used for colorectal cancer screening, screening of the upper and lower gastrointestinal tract can be performed with a single stool sample. We investigated the clinical usefulness of an H. pylori stool antigen assay using an S container. Materials A total of 347 patients who underwent esophagogastroduodenoscopy (EGD) were included. After the procedure, H. pylori stool antigen was measured using the S container and collection container recommended for H. pylori stool antigen (BL-stool collection container or BL container), and the qualitative outcomes of each were compared. A bioluminescent enzyme immunoassay (BLEIA) was used to measure H. pylori stool antigen. Results The overall agreement between S containers and BL containers was 100% (347/347), indicating that the qualitative outcomes were equivalent. As a secondary analysis, the results of the S container samples were evaluated according to the diagnosis made by physicians, and the overall agreement rate was 99.7% (345/346), indicating a high correlation. Conclusion The detection of H. pylori stool antigen using the S container is clinically useful because the results are equivalent to those obtained by the usual method. Screening of the upper and lower gastrointestinal tract is expected to be possible with a single stool sample in the future.

Keywords: BLEIA; Helicobacter pylori; stool antigen test.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Bacterial* / analysis
  • Endoscopy, Digestive System / methods
  • Feces* / chemistry
  • Feces* / microbiology
  • Female
  • Helicobacter Infections* / diagnosis
  • Helicobacter pylori* / immunology
  • Helicobacter pylori* / isolation & purification
  • Humans
  • Immunoenzyme Techniques* / methods
  • Luminescent Measurements* / methods
  • Male
  • Middle Aged
  • Occult Blood*

Substances

  • Antigens, Bacterial