We aimed to validate 2 types of antibodies, anti-CagA antibody and anti-East Asian CagA specific antibody (α-EAS antibody) for the determination of CagA status in Indonesia. We also confirmed the performance of α-EAS antibody for the detection of East Asian-type CagA H. pylori. Immunohistochemistry was performed using anti-CagA antibody and α-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 α-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 α-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 α-EAS antibody was not appropriate to discriminate between East Asian-type and non-East Asian-type CagA in Indonesia.

我们旨在验证两种类型的抗体，抗 CagA 抗体和抗东亚 CagA 特异性抗体（α-EAS 抗体），用于确定印度尼西亚的 CagA 状态。我们还证实了 α-EAS 抗体检测东亚型 CagA H. pylori 的性能. 使用抗 CagA 抗体和 α-EAS 抗体对来自总共 967 名印度尼西亚患者的胃活检标本进行免疫组织化学。免疫组织化学的诊断价值以基于 PCR 的测序为金标准进行评估。抗 CagA 抗体在确定 CagA 状态方面具有高灵敏度、特异性和准确度（分别为 87.0%、100% 和 98.8%）。α-EAS 抗体不适合用于 CagA 状态确定的目的，因为它具有低灵敏度 (23.9 %)。在检测东亚型 CagA 的 α-EAS 抗体中观察到高特异性 (97.6 %) 但灵敏度低 (41.2 %) 和准确度 (66.3 %)。使用抗 CagA 抗体免疫组化结果呈阳性的患者胃窦部（P < 0.001）和体部（P = 0.009）的单核细胞浸润评分显着较高。综上所述，