Sibel BAKIRCI ÜREYEN, Cumali EFE, Narin NASIROĞLU İMGA, Tankut KÖSEOĞLU, Ersan ÖZASLAN, Hasan TUNCA, Engin SENNAROĞLU

Helicobacter pylori CagA IgG pozitifliğinin gastrointestinal yakınmalar ve histopatolojik bulgular ile ilişkisi

Giriş ve Amaç: Güçlü immünojen ve sitotoksin olan Helicobacter pylori CagA dış membran proteinine karşı oluşan IgG tipi antikorların tespitine dayanarak yapılan serolojik testlerin, bu mikroorganizmaların neden olduğu patolojilerin tespitinde kullanımı son yıllarda yaygınlaşmaktadır. Bu çalışmada, Helicobacter pylori’ye karşı oluşmuş CagA IgG antikorlarının gastrointestinal yakınmalar, histopatolojik ve demografik veriler ile ilişkisinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Farklı gastrointestinal yakınmalar ile dahiliye polikliniğine başvurduktan sonra rutin değerlendirmelerinde üre nefes testi ile Helicobacter pylori açısından pozitif olarak tespit edildikten sonra tanı amaçlı özofagogastroduodenoskopik biyopsi yapılan18 yaş üzeri toplam 74 hasta çalışmamıza dahil edildi. Bu hastalarda CagA proteinine ait özgül IgG antikor varlığını saptamak için Enzyme Linked Immunosorbent Assay yöntemi kullanıldı. Bulgular: Yetmişdört hastanın 20’si kadın (%27) ve 54’ü erkekti (%73). Helicobacter pylori pozitif saptanan hastaların %62’sinde CagA IgG pozitifliği saptandı. CagA IgG pozitif hasta grubunda en sık saptanan gastrointestinal şikayet karın ağrısı ve en sık histopatolojik bulgu kronik aktif gastrit olarak tespit edildi. Sonuç: Helicobacter pylori enfeksiyonu ile ilişkili patolojilerin erken tanısında daha ucuz, pratik ve invaziv olmayan bu serolojik testlerin kullanımının standardize edilmesi için uzun dönemli ve büyük örneklem büyüklüğüne sahip çalışmaların yapılmasına ihtiyaç vardır.

Anahtar Kelimeler:

Helicobacter pylori, CagA IgG, gastrointestinal şikayetler, histopatoloji, üre-nefes testi

The relationship between Helicobacter pylori CagA IgG positivity and gastrointestinal complaints and histopathological findings

Background and Aims: In recent years, there has been a widespread use of serologic tests based on detection of IgG-type antibodies against Helicobacter pylori CagA outer membrane protein, which is a strong immunogen and cytotoxin, for the identification of pathologies caused by these microorganisms. The aim of this study was to evaluate the relationship between CagA IgG antibodies against Helicobacter pylori and gastrointestinal complaints and histopathological and demographic data. Material and Methods: This study included 74 adult patients who were admitted to the internal medicine outpatient clinic with different gastrointestinal complaints, showed Helicobacter pylori positivity in the urea breath test, and underwent esophagogastroduodenoscopic biopsy because of the diagnosis. The presence of IgG antibodies against CagA protein was detected by Enzyme Linked Immunosorbent Assay. Results: The 74 patients included 20 (27%) females and 54 (73%) males. CagA IgG positivity was detected in 62% of the Helicobacter pylori-positive patients. The most common gastrointestinal complaint was abdominal pain, and the most common histopathological finding was chronic active gastritis in the CagA IgG-positive patient group. Conclusion: Further long-term studies with a large sample size are needed to standardize the use of these serologic tests, which are inexpensive, practical, and noninvasive, in the early diagnosis of pathologies associated with Helicobacter pylori infection.

Keywords:

Helicobacter pylori, CagA IgG, gastrointestinal complaints, histopathology, urea breath test,

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