The validation of the Helicobacter pylori CagA typing by immunohistochemistry: nationwide application in Indonesia
The validation of the Helicobacter pylori CagA typing by immunohistochemistry: nationwide application in Indonesia
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DOI：
10.1016/j.acthis.2020.151594
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发表时间：
2020-09-01
影响因子：
2.5
通讯作者：
Yamaoka, Yoshio
中科院分区：
文献类型：
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作者：
Miftahussurur, Muhammad;Dalla Doohan;Yamaoka, Yoshio
我们的目的是验证两种抗体，抗CagA抗体和抗东亚CagA特异性抗体(α-EAS抗体)，以确定在印度尼西亚的CagA状态。我们还证实了α-EAS抗体用于检测东亚型CagA H.Pylori的性能。应用抗CagA抗体和α-EAS抗体对967例印尼患者的胃活检标本进行免疫组织化学染色。以聚合酶链式反应测序为金标准评价免疫组织化学的诊断价值。抗CagA抗体对判断CagA状态具有较高的敏感性、特异性和准确性(分别为87.0%、100%和98.8%)。α-EAS抗体灵敏度低(23.9%)，不适合用于CagA状态检测。α-EAS抗体检测东亚型CagA的特异性高(97.6%)，敏感性(41.2%)和准确性(66.3%)低。抗CagA抗体免疫组化阳性患者胃窦部(P<；0.001)和胃体部(P=0.009)单核细胞浸润积分显著高于对照组(P<0.05)。综上所述，抗CagA抗体仍适合在印度尼西亚用于判断CagA状态，而α-EAS抗体不适合用于区分印度尼西亚的东亚和非东亚类型的CagA。
We aimed to validate 2 types of antibodies, anti-CagA antibody and anti-East Asian CagA specific antibody (alpha-EAS antibody) for the determination of CagA status in Indonesia. We also confirmed the performance of alpha-EAS antibody for the detection of East Asian-type CagA H. pylori. Immunohistochemistry was performed using anti-CagA antibody and alpha-EAS antibody on gastric biopsy specimens from a total of 967 Indonesian patients. Diagnostic values of immunohistochemistry were evaluated with PCR-based sequencing as gold standard. Anti-CagA antibody had high sensitivity, specificity, and accuracy (87.0 %, 100 %, and 98.8 %, respectively) for determining CagA status. The alpha-EAS antibody was not suitable for the purpose of CagA status determination, as it had a low sensitivity (23.9 %). High specificity (97.6 %) but low sensitivity (41.2 %) and accuracy (66.3 %) was observed in alpha-EAS antibody to detect East Asian-type CagA. Patients with positive result of immunohistochemistry using anti-CagA antibody had significantly higher monocyte infiltration score in antrum (P < 0.001) and corpus (P = 0.009). In conclusion, the anti-CagA antibody is still suitable to be used in Indonesia for determining the CagA status, whilst the alpha-EAS antibody was not appropriate to discriminate between East Asian-type and non-East Asian-type CagA in Indonesia.