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Comparison of antigen and antibody detection tests used for diagnosing the Helicobacter pylori infection in symptomatic patients

Year 2010, Volume: 1 Issue: 4, 61 - 70, 05.04.2013
https://doi.org/10.12808/bcs.v1i4.13

Abstract

Abstract

Helicobacter pylori (H. pylori) infection is usually acquired in early childhood. H. pylori infection can be diagnosed by noninvasive techniques (serology, urea breath test, urine or blood, detection of H. pylori antigen in stool specimen) and by invasive techniques requiring endoscopy and biopsy (histological examination, culture, polymerase chain reaction). Recently, fecal antigen testing has been used successfully for the diagnosis of H. pylori infection in the Symptomatic Patients. We compared H. pylori fecal antigen and immunoglobulin G (IgG) serologic diagnostic methods in a population of symptomatic patients with H. pylori infection. The tests were performed with enzyme immunoassay (ELISA). All specimens were collected between January and October 2009 from 27 health center in Sivas-Turkey. The presence of clinical symptoms, such as dyspepsia and abdominal pain, was determined. A total of 705 patients were studied. Totally, 534 women (mean age 38.2) and 171 men (mean age 41.9) in this epidemiological investigation were enrolled. The H. pylori fecal antigen was positive in the stool specimens of 209 patients (29.6%) and the H. pylori IgG test was positive in the serum specimens of 487 (69.0%) patients. The fecoprevalance and seroprevalence of H. pylori infection were higher in women than in men (p < 0.05). ELISA fecal antigen testing is a practical and feasible alternative to traditional invasive diagnostic methods in high-prevalence populations. The fecal antigen test can also be used to establish cure of H. pylori infection.

Keywords: Helicobacter pylori, fecal antigen test, serum antibody test

Özet

Helicobacter pylori (H. pylori) enfeksiyonu genellikle erken çocukluk döneminde kazanılır. H. pylori enfeksiyonuna noninvaziv yöntemler (seroloji, üre nefes testi, idrar, kan veya dışkıda H. pylori antijeni varlığı) ve invaziv yöntemler gerektiren endoskopi ve biyopsi (histolojik inceleme, kültür, polimeraz zincir reaksiyonu) ile tanı konulabilir. Son zamanlarda, semptomlu hastalarda H. pylori enfeksiyonu tanısı için dışkıda antijen testi başarıyla kullanılmaktadır. Çalışmamızda, H. pylori enfeksiyonu ön tanısı konulmuş olan semptomlu hastalarda H. pylori dışkıda antijen ve immünglobulin G (IgG) serolojik tanı yöntemleri karşılaştırılmıştır. Testler enzim immünassay (ELISA) yöntemi ile çalışılmıştır. Bu çalışmadaki bütün örnekler Ocak-Ekim 2009 tarihleri arasında, Sivas'ta bulunan ve birinci basamak sağlık hizmeti veren 27 sağlık merkezinden toplanmıştır. Hastalarda dispepsi ve karın ağrısı gibi klinik belirtilerin varlığı tespit edilmiştir. Çalışmanın tamamı 705 hasta üzerinde yapılmıştır. Toplamda, 534 kadın (yaş ortalaması 38,2) ve 171 erkek (yaş ortalaması 41,9) hasta bu epidemiyolojik araştırmaya dahil edilmiştir. Dışkı örneklerinin 209'unda (%29,6) H. pylori dışkıda antijen testi ve serum örneklerinin de 487'sinde (%69,0) H. pylori IgG testi pozitif bulunmuştur. H. pylori fecoprevalansı ve seroprevalansı kadınlarda erkeklerde göre daha yüksek bulunmuştur (p <0,05).ELISA fekal antijen testi yüksek prevalansa sahip toplumlarda, geleneksel invaziv tanı yöntemleri içerisinde pratik ve uygulanabilir bir alternatif yöntemdir. H. pylori fekal antijen testi, enfeksiyonun tedavisini kanıtlamak için de kullanılabilir.

Anahtar sözcükler: Helicobacter pylori, dışkıda antijen testi, serumda antikor testi

References

  • Benjamin DG, Richard BC, Myles A, et al. Helicobacter pylori Infection in Children: Recommendations for Diagnosis and Treatment. J Pediatr Gastroenterol Nutr 2000; 31: 490-7.
  • Lake JM, Chey WD. Testing for Helicobacter pylori in the Clinical Setting. Frontiers in Bioscience 2001; 6: 129-36.
  • Kolts BE, Joseph B, Achem SR, Bianchi T, Monteiro C. Helicobacter pylori detection: a quality and cost analysis. Am J Gastroenterol 1993; 88: 650-5.
  • Gur G, Boyacioglu S, Demirhan B, et al. The importance of increasing the number of gastric biopsies in the diagnosis of Helicobacter pylori. Hepatogastroenterology Journal 1998; 45: 2219-23.
  • Bilgehan H. KlinikMikrobiyoloji, s: 143-6. BarışYayınları, FakültelerKitabevi, 2000. 10. Baskı, İzmir.
  • Henriksson AE, Edman AC, Nilsson I, Bergqvist D, Wadstrom T. Helicobacter pylori and the relation to other risk factors in patients with acute bleeding peptic ulcer. Scand J Gastroenterol 1998; 33: 1030-3.
  • Gönen Ö. Gastrointestinal kanamalar, s: 1060-5. İçinde: İliçin G, Ünal S, Biberoğlu K. Temel İç Hastalıkları. 1996, 1. Cilt, Güneş kitabevi, Ankara.
  • Labenz J, Borsch G. Role of Helicobacter pylori eradication in the prevention of peptic ulcer bleeding relapse. Digestion 1994; 55: 19-23.
  • Jaspersen D. Helicobacter pylori eradication: the best long-term propylaxis for ulcer bleeding reccurence? Endoscopy 1995; 27(8): 622-5.
  • Laheij RJF, Boer WA, Jansen JBM, Lier HJ, Sneeberger PM, Verbeek. AL. Diagnostic performance of biopsy-based methods for determination of Helicobacter pylori infection without a reference standard. J Clin Epidemiol 2000; 53: 742-6.
  • Kaklıkkaya N, Çubukçu K, Aydın F, Yetişkul S, Yazıcı Y, Kapıcıoğlu S. Gastrik biyopsi örneklerinden Helicobacter pylori‘nin belirlenmesinde polimeraz zincir reaksiyonunun önemi. İnfek Derg 2001; 15: 307-10.
  • Misawa K, Kumagai T, Hosogaya S, et al. Clinical and etiological studies of IgG antibodies to Helicobacter pylori detected by enzyme-linked immunosorbent assay. Rinsho Byori 1995; 43(4): 375-80.
  • Luzza F, Maletta M, Imeneo M, et al. Salivary-specific immunoglobulin G in the diagnosis of Helicobacter pylori infection in dyspeptic patients. Am J Gastroenterol 1995; 90(10): 1820-3.
  • Friis L, Engstrand L, Edling C. Prevalance of Helicobacter pylori infection among sewage workers. Scand J Work Environ Health 1996; 22(5): 364-8.
  • Us D, Hasçelik G. Seroprevalance of Helicobacter pylori infection in an Asymptomatic Turkish population. J Infect 1998; 37(2): 148-50.
  • Fraser AG, Scragg R, Metcalf P, McCullough S, Yeates NJ. Prevalance of Helicobacter pylori infection in different ethnic groups in New Zealand children and adults. Aust N Z J Med 1996; 26(5): 646-651.
  • Falk GW. Mide ve Duedonum Hastalıkları, pp: 332-44. Andreoli TE (ed), Cecil Essentials of Medicine. 2001, 5nd ed. Philadelphia.
  • Kocazeybek B, Memişoğlu R, Memişoğlu N, Arıtürk S, Ordu A, Köksal V, ve ark. Helicobacter pylori infeksiyonlarında dışkıda antijen saptama: Tanı ve tedavi sonrası eradikasyonunun izlenmesindeki rolü. İnfek Derg 2003;17:399-403.
  • Naous A, Al-Tannir M, Naja Z, Ziade F, El-Rajab M. Fecoprevalence and determinants of Helicobacter pylori infection among asymptomatic children in Lebanon. J Med Liban 2007; 55(3):138-44.
  • Alim A, Ataş AD, Güneş T, Ataş M, Yıldırım M, Öztekin A, Yıldızbaş H. Sivas İl Merkezinde, Semptomatik ve Asemptomatik Yetişkin Bireylerde Helicobacter pylori Seroprevalansı. C.Ü. Tıp Fak Derg 2004; 26(2): 75-80.
  • Cardenas VM, Dominguez DC, Puentes FA, Aragaki CC, Goodman KJ, Graham DY, Fukuda Y. Evaluation of a novel stool native catalase antigen test for Helicobacter pylori infection in asymptomatic North American children. J Pediatr Gastroenterol Nutr 2008; 46(4): 399-402.
  • Fox JG, Megraud F; Helicobacter, pp: 947-62. In: Murray PR (ed). Manual of Clinical Microbiology. 2009, 9th ed. Volum 1, Ankara.
  • Öztürk H, Şenocak ME, Uzunalimoğlu B, Hasçelik G, Büyükpamukçu N, Hiçsönmez A. Helicobacter pylori infection in symptomatic and asymptomatic children: a prospective clinical study. Eur J Pediatr Surg 1996; 6(5): 265-9.
  • Sandıkçı MÜ, Köksal F. Helicobacter İnfeksiyonları, s: 1005-9. İçinde: Topçu AW, Söyletir G, Doğanay M (editörler), İnfeksion Hastalıkları. 1996, Nobel Tıp Kitabevleri, İstanbul.
  • Perry S, Sanchez ML, Yang S, et al. Gastroenteritis and Transmission of Helicobacter pylori Infection in Households. Emerging Infectious Diseases, www.cdc.gov/eid Vol. 12, No. 11, November 2006.
  • Gulcan EM, Varol A, Kutlu T, ve ark. Helicobacter pylori Stool Antigen Test, Indian J Pediatr 2005; 72: 675-8.
  • Yılmaz Ö, Şen N, Soytürk M, Tankurt İE. Helicobacter pylori tanısında iki farklı dışkı antijen testinin karşılaştırılması, p: 294. XI. Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Kongresi özet kitabı. 30 Mart-3 Nisan 2003, İstanbul.
  • Chiba N, van Zanten S, Sinclair P, et al. Treating Helicobacter pylori infection in primary care patients with uninvestigated dyspepsia: the Canadian adult dyspepsia empiric treatment Helicobacter pylori positive (CADET-H. pylori) randomised controlled trial. BMJ 2002; 324: 1012-16.
  • Ozcay F, Kocak N, Temizel IN, et al. Helicobacter pylori infection in Turkish children: comparison of diagnostic tests, evaluation of eradication rate, and changes in symptoms after eradication. Helicobacter 2004; 9: 242-8.
  • Sokucu S, Suoglu OD, Turkkan E, Elkabes B, Ozden T, Saner G. Helicobacter pylori infection in Turkish children with gastrointestinal symptoms and evaluation of serology. Turk J Pediatr 2002; 44: 102-8.
  • Meijer BC, Thijs JC, Kleibeuker JH, et al. Evaluation of eight enzyme immunoassays for detection of immunoglobulin G against Helicobacter pylori. J Clin Microbiol 1997; 35: 292-4.
  • Salles-Montaudon N, Dertheil S, Broutet N, et al. Detecting Helicobacter pylori infection in hospitalized frail older patients: the challenge. J Am Geriatr Soc 2002; 50: 1674-80.
  • Konstantopoulos N, Rüssmann H, Tasch C, et al. Evaluation of the Helicobacter pylori stool antigen test (HpSA) for detection of Helicobacter pylori infection in children. Am J Gastroenterol 2001; 96(3): 677-83.
  • Cherian S, Burgner DP, Carson CF, Sanfilippo FM, Cook AG, Forbes DA. Diagnosis of Helicobacter pylori infection in a high-prevalence pediatric population: a comparison of 2 fecal antigen testing methods and serology. J Pediatr Gastroenterol Nutr 2008; 47(2):130-5.
  • Agha-Amiri K, Mainz D, Peitz U, Kahl S, Leodolter A, Malfertheiner P. Evaluation of an enzyme immunoassay for detecting Helicobacter pylori antigens in human stool samples. Z Gastroenterol 1999; 37(12): 1145-9.
  • Chen TS, Li FY, Chang FY, Lee SD. Immunoglobulin G antibody against Helicobacter pylori: clinical implications of levels found in serum. Clin Diagn Lab Immunol 2002; 9: 1044-8.
  • Cardenas VM, Dominguez DC, Puentes FA, et al. Evaluation of a novel stool native catalase antigen test for Helicobacter pylori infection in asymptomatic North American children. J Pediatr Gastroenterol Nutr 2008; 46(4): 399-402.
  • Buyukbaba-Boral O, Gonullu N, Anğ-Kucuker M. Dışkı Örneklerinde Helicobacter pylori Antijeninin Saptanmasında ELISA ve İmmunokart Testinin Karşılaştırılması, Turk Mikrobiyol Cem Derg 2004; 34:13-5.
  • Peitz U, Leodolter A, Kahl S, et al. Antigen stool test for assessment of Helicobacter pylori infection in patients with upper gastrointestinal bleeding. Aliment Pharmacol Ther 2003; 17: 1075-84.
  • Erzin Y, Aslan M, Dobrucali A, Altun S, Erdamar S, ve ark. Dispeptik Hastalarda Anti-Helicobacter pylori IgG Elisa Kitinin Helicobacter pylori İnfeksiyonunun Birincil Tanısındaki Etkinliğinin Değerlendirilmesi. İnfek Derg 2007; 21(3): 129-33.
Year 2010, Volume: 1 Issue: 4, 61 - 70, 05.04.2013
https://doi.org/10.12808/bcs.v1i4.13

Abstract

References

  • Benjamin DG, Richard BC, Myles A, et al. Helicobacter pylori Infection in Children: Recommendations for Diagnosis and Treatment. J Pediatr Gastroenterol Nutr 2000; 31: 490-7.
  • Lake JM, Chey WD. Testing for Helicobacter pylori in the Clinical Setting. Frontiers in Bioscience 2001; 6: 129-36.
  • Kolts BE, Joseph B, Achem SR, Bianchi T, Monteiro C. Helicobacter pylori detection: a quality and cost analysis. Am J Gastroenterol 1993; 88: 650-5.
  • Gur G, Boyacioglu S, Demirhan B, et al. The importance of increasing the number of gastric biopsies in the diagnosis of Helicobacter pylori. Hepatogastroenterology Journal 1998; 45: 2219-23.
  • Bilgehan H. KlinikMikrobiyoloji, s: 143-6. BarışYayınları, FakültelerKitabevi, 2000. 10. Baskı, İzmir.
  • Henriksson AE, Edman AC, Nilsson I, Bergqvist D, Wadstrom T. Helicobacter pylori and the relation to other risk factors in patients with acute bleeding peptic ulcer. Scand J Gastroenterol 1998; 33: 1030-3.
  • Gönen Ö. Gastrointestinal kanamalar, s: 1060-5. İçinde: İliçin G, Ünal S, Biberoğlu K. Temel İç Hastalıkları. 1996, 1. Cilt, Güneş kitabevi, Ankara.
  • Labenz J, Borsch G. Role of Helicobacter pylori eradication in the prevention of peptic ulcer bleeding relapse. Digestion 1994; 55: 19-23.
  • Jaspersen D. Helicobacter pylori eradication: the best long-term propylaxis for ulcer bleeding reccurence? Endoscopy 1995; 27(8): 622-5.
  • Laheij RJF, Boer WA, Jansen JBM, Lier HJ, Sneeberger PM, Verbeek. AL. Diagnostic performance of biopsy-based methods for determination of Helicobacter pylori infection without a reference standard. J Clin Epidemiol 2000; 53: 742-6.
  • Kaklıkkaya N, Çubukçu K, Aydın F, Yetişkul S, Yazıcı Y, Kapıcıoğlu S. Gastrik biyopsi örneklerinden Helicobacter pylori‘nin belirlenmesinde polimeraz zincir reaksiyonunun önemi. İnfek Derg 2001; 15: 307-10.
  • Misawa K, Kumagai T, Hosogaya S, et al. Clinical and etiological studies of IgG antibodies to Helicobacter pylori detected by enzyme-linked immunosorbent assay. Rinsho Byori 1995; 43(4): 375-80.
  • Luzza F, Maletta M, Imeneo M, et al. Salivary-specific immunoglobulin G in the diagnosis of Helicobacter pylori infection in dyspeptic patients. Am J Gastroenterol 1995; 90(10): 1820-3.
  • Friis L, Engstrand L, Edling C. Prevalance of Helicobacter pylori infection among sewage workers. Scand J Work Environ Health 1996; 22(5): 364-8.
  • Us D, Hasçelik G. Seroprevalance of Helicobacter pylori infection in an Asymptomatic Turkish population. J Infect 1998; 37(2): 148-50.
  • Fraser AG, Scragg R, Metcalf P, McCullough S, Yeates NJ. Prevalance of Helicobacter pylori infection in different ethnic groups in New Zealand children and adults. Aust N Z J Med 1996; 26(5): 646-651.
  • Falk GW. Mide ve Duedonum Hastalıkları, pp: 332-44. Andreoli TE (ed), Cecil Essentials of Medicine. 2001, 5nd ed. Philadelphia.
  • Kocazeybek B, Memişoğlu R, Memişoğlu N, Arıtürk S, Ordu A, Köksal V, ve ark. Helicobacter pylori infeksiyonlarında dışkıda antijen saptama: Tanı ve tedavi sonrası eradikasyonunun izlenmesindeki rolü. İnfek Derg 2003;17:399-403.
  • Naous A, Al-Tannir M, Naja Z, Ziade F, El-Rajab M. Fecoprevalence and determinants of Helicobacter pylori infection among asymptomatic children in Lebanon. J Med Liban 2007; 55(3):138-44.
  • Alim A, Ataş AD, Güneş T, Ataş M, Yıldırım M, Öztekin A, Yıldızbaş H. Sivas İl Merkezinde, Semptomatik ve Asemptomatik Yetişkin Bireylerde Helicobacter pylori Seroprevalansı. C.Ü. Tıp Fak Derg 2004; 26(2): 75-80.
  • Cardenas VM, Dominguez DC, Puentes FA, Aragaki CC, Goodman KJ, Graham DY, Fukuda Y. Evaluation of a novel stool native catalase antigen test for Helicobacter pylori infection in asymptomatic North American children. J Pediatr Gastroenterol Nutr 2008; 46(4): 399-402.
  • Fox JG, Megraud F; Helicobacter, pp: 947-62. In: Murray PR (ed). Manual of Clinical Microbiology. 2009, 9th ed. Volum 1, Ankara.
  • Öztürk H, Şenocak ME, Uzunalimoğlu B, Hasçelik G, Büyükpamukçu N, Hiçsönmez A. Helicobacter pylori infection in symptomatic and asymptomatic children: a prospective clinical study. Eur J Pediatr Surg 1996; 6(5): 265-9.
  • Sandıkçı MÜ, Köksal F. Helicobacter İnfeksiyonları, s: 1005-9. İçinde: Topçu AW, Söyletir G, Doğanay M (editörler), İnfeksion Hastalıkları. 1996, Nobel Tıp Kitabevleri, İstanbul.
  • Perry S, Sanchez ML, Yang S, et al. Gastroenteritis and Transmission of Helicobacter pylori Infection in Households. Emerging Infectious Diseases, www.cdc.gov/eid Vol. 12, No. 11, November 2006.
  • Gulcan EM, Varol A, Kutlu T, ve ark. Helicobacter pylori Stool Antigen Test, Indian J Pediatr 2005; 72: 675-8.
  • Yılmaz Ö, Şen N, Soytürk M, Tankurt İE. Helicobacter pylori tanısında iki farklı dışkı antijen testinin karşılaştırılması, p: 294. XI. Türk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Kongresi özet kitabı. 30 Mart-3 Nisan 2003, İstanbul.
  • Chiba N, van Zanten S, Sinclair P, et al. Treating Helicobacter pylori infection in primary care patients with uninvestigated dyspepsia: the Canadian adult dyspepsia empiric treatment Helicobacter pylori positive (CADET-H. pylori) randomised controlled trial. BMJ 2002; 324: 1012-16.
  • Ozcay F, Kocak N, Temizel IN, et al. Helicobacter pylori infection in Turkish children: comparison of diagnostic tests, evaluation of eradication rate, and changes in symptoms after eradication. Helicobacter 2004; 9: 242-8.
  • Sokucu S, Suoglu OD, Turkkan E, Elkabes B, Ozden T, Saner G. Helicobacter pylori infection in Turkish children with gastrointestinal symptoms and evaluation of serology. Turk J Pediatr 2002; 44: 102-8.
  • Meijer BC, Thijs JC, Kleibeuker JH, et al. Evaluation of eight enzyme immunoassays for detection of immunoglobulin G against Helicobacter pylori. J Clin Microbiol 1997; 35: 292-4.
  • Salles-Montaudon N, Dertheil S, Broutet N, et al. Detecting Helicobacter pylori infection in hospitalized frail older patients: the challenge. J Am Geriatr Soc 2002; 50: 1674-80.
  • Konstantopoulos N, Rüssmann H, Tasch C, et al. Evaluation of the Helicobacter pylori stool antigen test (HpSA) for detection of Helicobacter pylori infection in children. Am J Gastroenterol 2001; 96(3): 677-83.
  • Cherian S, Burgner DP, Carson CF, Sanfilippo FM, Cook AG, Forbes DA. Diagnosis of Helicobacter pylori infection in a high-prevalence pediatric population: a comparison of 2 fecal antigen testing methods and serology. J Pediatr Gastroenterol Nutr 2008; 47(2):130-5.
  • Agha-Amiri K, Mainz D, Peitz U, Kahl S, Leodolter A, Malfertheiner P. Evaluation of an enzyme immunoassay for detecting Helicobacter pylori antigens in human stool samples. Z Gastroenterol 1999; 37(12): 1145-9.
  • Chen TS, Li FY, Chang FY, Lee SD. Immunoglobulin G antibody against Helicobacter pylori: clinical implications of levels found in serum. Clin Diagn Lab Immunol 2002; 9: 1044-8.
  • Cardenas VM, Dominguez DC, Puentes FA, et al. Evaluation of a novel stool native catalase antigen test for Helicobacter pylori infection in asymptomatic North American children. J Pediatr Gastroenterol Nutr 2008; 46(4): 399-402.
  • Buyukbaba-Boral O, Gonullu N, Anğ-Kucuker M. Dışkı Örneklerinde Helicobacter pylori Antijeninin Saptanmasında ELISA ve İmmunokart Testinin Karşılaştırılması, Turk Mikrobiyol Cem Derg 2004; 34:13-5.
  • Peitz U, Leodolter A, Kahl S, et al. Antigen stool test for assessment of Helicobacter pylori infection in patients with upper gastrointestinal bleeding. Aliment Pharmacol Ther 2003; 17: 1075-84.
  • Erzin Y, Aslan M, Dobrucali A, Altun S, Erdamar S, ve ark. Dispeptik Hastalarda Anti-Helicobacter pylori IgG Elisa Kitinin Helicobacter pylori İnfeksiyonunun Birincil Tanısındaki Etkinliğinin Değerlendirilmesi. İnfek Derg 2007; 21(3): 129-33.
There are 40 citations in total.

Details

Primary Language English
Journal Section Basic Sciences
Authors

Ahmet Alim

Mehmet Ataş This is me

Turabi Güneş This is me

Suzan Özkan This is me

Nilgün Dündar This is me

Publication Date April 5, 2013
Published in Issue Year 2010 Volume: 1 Issue: 4

Cite

APA Alim, A., Ataş, M., Güneş, T., Özkan, S., et al. (2013). Comparison of antigen and antibody detection tests used for diagnosing the Helicobacter pylori infection in symptomatic patients. Basic and Clinical Sciences, 1(4), 61-70. https://doi.org/10.12808/bcs.v1i4.13
AMA Alim A, Ataş M, Güneş T, Özkan S, Dündar N. Comparison of antigen and antibody detection tests used for diagnosing the Helicobacter pylori infection in symptomatic patients. Basic and Clinical Sciences. April 2013;1(4):61-70. doi:10.12808/bcs.v1i4.13
Chicago Alim, Ahmet, Mehmet Ataş, Turabi Güneş, Suzan Özkan, and Nilgün Dündar. “Comparison of Antigen and Antibody Detection Tests Used for Diagnosing the Helicobacter Pylori Infection in Symptomatic Patients”. Basic and Clinical Sciences 1, no. 4 (April 2013): 61-70. https://doi.org/10.12808/bcs.v1i4.13.
EndNote Alim A, Ataş M, Güneş T, Özkan S, Dündar N (April 1, 2013) Comparison of antigen and antibody detection tests used for diagnosing the Helicobacter pylori infection in symptomatic patients. Basic and Clinical Sciences 1 4 61–70.
IEEE A. Alim, M. Ataş, T. Güneş, S. Özkan, and N. Dündar, “Comparison of antigen and antibody detection tests used for diagnosing the Helicobacter pylori infection in symptomatic patients”, Basic and Clinical Sciences, vol. 1, no. 4, pp. 61–70, 2013, doi: 10.12808/bcs.v1i4.13.
ISNAD Alim, Ahmet et al. “Comparison of Antigen and Antibody Detection Tests Used for Diagnosing the Helicobacter Pylori Infection in Symptomatic Patients”. Basic and Clinical Sciences 1/4 (April 2013), 61-70. https://doi.org/10.12808/bcs.v1i4.13.
JAMA Alim A, Ataş M, Güneş T, Özkan S, Dündar N. Comparison of antigen and antibody detection tests used for diagnosing the Helicobacter pylori infection in symptomatic patients. Basic and Clinical Sciences. 2013;1:61–70.
MLA Alim, Ahmet et al. “Comparison of Antigen and Antibody Detection Tests Used for Diagnosing the Helicobacter Pylori Infection in Symptomatic Patients”. Basic and Clinical Sciences, vol. 1, no. 4, 2013, pp. 61-70, doi:10.12808/bcs.v1i4.13.
Vancouver Alim A, Ataş M, Güneş T, Özkan S, Dündar N. Comparison of antigen and antibody detection tests used for diagnosing the Helicobacter pylori infection in symptomatic patients. Basic and Clinical Sciences. 2013;1(4):61-70.