Comparative study of serology and histology based detection of Helicobacter pylori infections: a large population-based study of 7,241 subjects from China

Two detection methods for H. pylori infections, i.e. serological antibody titer measurements by Hp-ELISA and histological scoring by HE staining, have been compared to investigate the relationship between the diagnosis methods, to clarify the application scope of each diagnosis method and to determine its influencing factors. In the 7,241 subjects who participated in gastric cancer screening, H. pylori infection rate was 70.14% by the Hp-HE method and 41.87% by the Hp-ELISA method when 34EIU was recognized as the cut-off value. The IgG titers increased with the elevation of HE scores; however, the two methods were not closely correlated among those in different gastric disease status. Age, gender and drinking status did not have significant impact on the relationship between the two methods; however, smoking status seemed to significantly influence the correlation of the two diagnosis methods. In conclusion, it was necessary to reevaluate the cut-off value when using ELISA test kits in different population groups. In most cases, the results of two H. pylori infection diagnosis methods show high correlation. However, this relationship can be affected by smoking and gastric diseases status. Additionally, the dynamic change of H. pylori antibody titers is an indicator of gastric disease development.