Fingerstick Helicobacter pylori antibody test: better than laboratory serological testing?

Am J Gastroenterol. 1999 Dec;94(12):3464-7. doi: 10.1111/j.1572-0241.1999.01510.x.


Objective: Antibody testing is the recommended method to screen for Helicobacter pylori (H. pylori) infection. Whole-blood fingerstick antibody tests are simple, in-office tests providing rapid results, but the accuracy of first-generation tests was lower than other diagnostic tests. We assessed a new whole-blood antibody test, using endoscopic biopsy tests as a "gold standard," and compared it with a laboratory quantitative serological test.

Methods: Two hundred-one patients not previously treated for H. pylori who were undergoing endoscopy had gastric biopsies for rapid urease test and histological examination; whole-blood antibody tests and quantitative serological tests were also performed. Two separate gold standards for H. pylori infection were employed: either rapid urease test or histological exam positive; and both rapid urease test and histological exam positive.

Results: Sensitivities for whole-blood test versus quantitative serology with gold standard 1 (either biopsy test positive) were 86% versus 92% (95% confidence interval [CI] of difference, -2-14%; p = 0.19) and specificities were 88% versus 77% (95% CI of difference, 0.4-22%; p = 0.052). Sensitivities with gold standard 2 (both biopsy tests positive) were 90% versus 94% (95% CI of difference, -4-12%; p = 0.41) and specificities were 79% versus 67% (95% CI of difference, 1-24%; p = 0.048).

Conclusions: New generation in-office, whole-blood antibody tests that can achieve a sensitivity and specificity similar to or better than those of widely used quantitative laboratory serological tests may be used as the initial screening tests of choice for H. pylori.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antibodies, Bacterial / blood*
  • Biopsy
  • Blood Specimen Collection*
  • Endoscopy
  • Enzyme-Linked Immunosorbent Assay*
  • Female
  • Gastric Mucosa / pathology
  • Gastritis / diagnosis*
  • Gastritis / immunology
  • Gastritis / pathology
  • Helicobacter Infections / diagnosis*
  • Helicobacter Infections / immunology
  • Helicobacter Infections / pathology
  • Helicobacter pylori / immunology*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Reference Standards


  • Antibodies, Bacterial