Trevisani L, Sartori S, Galvani F, Rossi M R, Ruina M, Chiamenti C, Caselli M
Medical Department, S. Anna Hospital, Ferrara, Italy.
Am J Gastroenterol. 1999 Jul;94(7):1830-3. doi: 10.1111/j.1572-0241.1999.01213.x.
There is an increasing interest in noninvasive tests for detecting Helicobacter pylori (H. pylori) infection. Unlike serological and urea breath tests, the possibility of searching for H. pylori in feces has been scarcely investigated. The aim of this prospective pilot study was to evaluate the usefulness of a new enzyme immunoassay for detecting H. pylori antigens in feces, as a predictor of H. pylori status in the pre- and posttreatment settings.
One hundred and fifty-four symptomatic, anti-H. pylori untreated patients (Group A) and 116 anti-H. pylori treated patients (Group B) underwent gastroscopy with biopsies of the antrum and corpus for histology (H) and rapid urease test (RUT). In the anti-H. pylori treated group, a 13C-urea breath test (UBT) was also performed. In Group A, H. pylori status was defined as positive or negative when both H and RUT gave concordant positive or negative results. In Group B, the patients were considered eradicated if all three tests were negative. A stool specimen was collected from all patients the day after gastroscopy, and tested by using an enzyme immunoassay commercial kit for detecting H. pylori antigens in feces (HpSAT).
Eighty-five patients in Group A (55%) and 44 in Group B (38%) were H. pylori infected. On the whole, HpSAT showed a sensitivity of 94% and specificity of 86%. In Group A and Group B, sensitivity and specificity were 94% versus 93%, and 90% versus 82%, respectively (p < 0.05).
HpSAT seems to be a reliable method for predicting H. pylori status in anti-H. pylori untreated patients. Conversely, the test appears less suitable to evaluate the outcome of the eradicating treatment. Consequently, it is likely to be accepted for the primary diagnosis of H. pylori status, particularly in dyspeptic young patients.
对检测幽门螺杆菌（H. pylori）感染的非侵入性检测方法的兴趣日益增加。与血清学和尿素呼气试验不同，在粪便中检测H. pylori的可能性几乎未被研究。这项前瞻性试点研究的目的是评估一种用于检测粪便中H. pylori抗原的新型酶免疫测定法的实用性，作为治疗前和治疗后H. pylori状态的预测指标。
154例有症状、未接受抗H. pylori治疗的患者（A组）和116例接受抗H. pylori治疗的患者（B组）接受了胃镜检查，并取胃窦和胃体组织进行组织学检查（H）和快速尿素酶试验（RUT）。在抗H. pylori治疗组中，还进行了13C尿素呼气试验（UBT）。在A组中，当H和RUT结果一致为阳性或阴性时，H. pylori状态被定义为阳性或阴性。在B组中，如果所有三项检测均为阴性，则认为患者已根除。所有患者在胃镜检查后第二天收集粪便样本，并使用一种用于检测粪便中H. pylori抗原的酶免疫测定商业试剂盒（HpSAT）进行检测。
A组85例患者（55%）和B组44例患者（38%）感染了H. pylori。总体而言，HpSAT的敏感性为94%，特异性为86%。在A组和B组中，敏感性和特异性分别为94%对93%，以及90%对82%（p<0.05）。
HpSAT似乎是预测未接受抗H. pylori治疗患者H. pylori状态的可靠方法。相反，该检测似乎不太适合评估根除治疗的结果。因此，它可能被接受用于H. pylori状态的初步诊断，特别是在消化不良的年轻患者中。
