Diagnostic Accuracy of Serum Antibody, Urine Antibody, and Stool Antigen Tests for Helicobacter pylori in Japan: A Systematic Review and Meta-Analysis

IF 4.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Helicobacter Pub Date : 2026-08-16 DOI:10.1111/hel.70157

Chikamasa Ichita, Fumiaki Ishibashi, Yasuhiro Hagiwara, Ayaka Takasu, Yuichiro Kemmoto, Ran Li, Chika Kusano, Tianyi Wei, Yutaka Matsuyama, Nobutake Yamamichi, Manami Inoue, Hideki Ishikawa, Takuji Gotoda

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引用次数: 0

Abstract

Background

Non-invasive Helicobacter pylori (H. pylori) tests are widely used in clinical practice in Japan; however, their diagnostic accuracy may vary with the composition of the target population, and no systematic review has synthesized their performance specifically in Japanese populations. Therefore, we conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of serum antibody, urine antibody, and stool antigen tests for H. pylori infection in Japanese populations.

Materials and Methods

MEDLINE, Embase, and Ichushi-Web were searched for studies published between 2005 and 2024 evaluating serum antibody, urine antibody, or stool antigen tests in Japanese participants. The primary objective involved evaluation of diagnostic accuracy for current H. pylori infection, and the secondary objective involved assessment of accuracy for ever-infected individuals. Summary estimates were calculated using bivariate random-effects models. A subgroup analysis was performed under clinically relevant conditions, restricted to studies without previously infected individuals, with composite reference standards, and without application of post hoc cutoff values.

Results

Among 806 publications, 43 studies were selected (serum antibody, 29; urine antibody, six; stool antigen, eight). For diagnosing current H. pylori infection, the summary sensitivity/specificity measured 0.922/0.956 for serum antibody, 0.885/0.970 for urine antibody, and 0.928/0.972 for stool antigen tests. For diagnosing ever-infected individuals, the summary sensitivity/specificity measured 0.908/0.960 for serum antibody and 0.888/0.969 for stool antigen. Under clinically relevant conditions, serum antibody and stool antigen yielded sensitivities/specificities of 0.908/0.968 and 0.935/0.985, respectively. In serum antibody studies, studies with previously infected individuals showed lower accuracy (sensitivity/specificity, 0.876/0.861) than studies without previously infected individuals (0.929/0.967).

Conclusions

Serum antibody and stool antigen tests demonstrated high diagnostic accuracy for current H. pylori infection in Japanese populations, although accuracy declined in studies with previously infected individuals.

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日本幽门螺杆菌血清抗体、尿抗体和粪便抗原检测的诊断准确性：系统回顾和荟萃分析

背景：无创幽门螺杆菌（h.p ylori）检测在日本的临床实践中得到广泛应用；然而，它们的诊断准确性可能因目标人群的组成而异，并且没有系统的评价综合了它们在日本人群中的具体表现。因此，我们进行了一项系统回顾和荟萃分析，以评估日本人群中血清抗体、尿抗体和粪便抗原检测对幽门螺杆菌感染的诊断准确性。材料和方法：检索MEDLINE、Embase和Ichushi-Web，检索2005年至2024年间发表的评价日本受试者血清抗体、尿抗体或粪便抗原检测的研究。主要目的是评估当前幽门螺杆菌感染的诊断准确性，次要目的是评估曾经感染的个体的准确性。使用双变量随机效应模型计算汇总估计值。在临床相关条件下进行亚组分析，仅限于没有先前感染个体的研究，使用复合参考标准，并且没有应用事后截止值。结果：在806篇文献中，筛选出43篇（血清抗体29篇，尿抗体6篇，粪便抗原8篇）。诊断当前幽门螺杆菌感染，血清抗体、尿抗体、粪便抗原的总敏感性/特异性分别为0.922/0.956、0.885/0.970和0.928/0.972。血清抗体的总敏感性/特异性为0.908/0.960，粪便抗原的总敏感性/特异性为0.888/0.969。在临床相关条件下，血清抗体和粪便抗原的敏感性/特异性分别为0.908/0.968和0.935/0.985。在血清抗体研究中，有既往感染者的研究的准确性（敏感性/特异性，0.876/0.861）低于没有既往感染者的研究（0.929/0.967）。结论：血清抗体和粪便抗原检测显示日本人群中当前幽门螺杆菌感染的诊断准确性很高，尽管在先前感染个体的研究中准确性有所下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Helicobacter 医学-微生物学

CiteScore

8.40

自引率

9.10%

发文量

审稿时长

2 months

期刊介绍： Helicobacter is edited by Professor David Y Graham. The editorial and peer review process is an independent process. Whenever there is a conflict of interest, the editor and editorial board will declare their interests and affiliations. Helicobacter recognises the critical role that has been established for Helicobacter pylori in peptic ulcer, gastric adenocarcinoma, and primary gastric lymphoma. As new helicobacter species are now regularly being discovered, Helicobacter covers the entire range of helicobacter research, increasing communication among the fields of gastroenterology; microbiology; vaccine development; laboratory animal science.