免疫组织化学染色与改良吉姆萨染色在非洲人群中检测幽门螺杆菌感染的比较

Comparison of immunohistochemical and modified Giemsa stains for demonstration of Helicobacter pylori infection in an African population.

作者信息

Wabinga H R

机构信息

Department of Pathology, Faculty of Medicine Makerere University, PO Box 7072 Kampala, Uganda.

出版信息

Afr Health Sci. 2002 Aug;2(2):52-5.

PMID:12789102

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2141568/

Abstract

BACKGROUND

Modified Giemsa staining has been favoured by many researchers because it is easy to perform but, like many other stains, demonstration of the bacteria depends on its morphology. It has been arged in some research circles that some of the organisms in the gastric mucosa may not be true H.pylori. Immunohistochemical techniques have been developed and make use of anti H.pylori antibody, which reacts, with somatic antigens of the whole bacteria and have been found to correlate well with the presence of the bacteria.

OBJECTIVE

To ascertain the efficacy of modified Giemsa stain in an African setting where H.Pylori seems quite prevalent.

STUDY DESIGN

A laboratory-based study of two diagnostic tests in which modified Giema stain was compared with immunohistochemistry.

METHODS

A total of 48 consecutive autopsy cases with no upper gastro intestinal diseases had their gastric mucosa stained for demonstration of H.pylori using both modified Giemsa and immunohisto chemical staining techniques.

RESULTS

Twenty-seven cases of H.pylori were demonstrated by both techniques and 14 cases were not identified by the two staining methods. In 2 cases immunostain could not demonstrate the bacteria but they were identified with modified Giemsa stain while in 5 cases the bacteria were identified by immunostain but not with modified Giemsa stain. The sensitivity of modified Giemsa stain was 85% (CI 66.5-98.8) while the specificity was 89% (CI 60.4 - 97.8). The positive predictive value of modified Giemsa stain was 93% CI 75 - 98.8%) while the negative predictive value was 74% (CI 48.6 - 89.9). The kappa statistic comparing the 2 stains was 0.69 (p value 0.00001) giving a good agreement between the two tests.

CONCLUSION

With the above results the modified Giemsa stain, which is readily available in most African laboratories, is recommenced for diagnosis of H.pylori, a prevalent infection in Africa.

摘要

背景

改良吉姆萨染色法因操作简便而受到许多研究人员的青睐，但与许多其他染色方法一样，细菌的鉴定依赖于其形态。在一些研究领域中有人认为，胃黏膜中的某些微生物可能并非真正的幽门螺杆菌。免疫组织化学技术已得到发展，并利用抗幽门螺杆菌抗体与整个细菌的菌体抗原发生反应，且已发现该技术与细菌的存在情况具有良好的相关性。

目的

在幽门螺杆菌似乎相当普遍的非洲地区，确定改良吉姆萨染色法的有效性。

研究设计

一项基于实验室的研究，对两种诊断测试进行比较，即将改良吉姆萨染色法与免疫组织化学法进行比较。

方法

总共48例无上部胃肠道疾病的连续尸检病例，其胃黏膜采用改良吉姆萨染色法和免疫组织化学染色技术进行幽门螺杆菌检测。

结果

两种技术均检测出27例幽门螺杆菌，两种染色方法均未鉴定出14例。在2例中，免疫染色未能显示出细菌，但改良吉姆萨染色法鉴定出了这些细菌；而在5例中，免疫染色鉴定出了细菌，但改良吉姆萨染色法未鉴定出。改良吉姆萨染色法的敏感性为85%（可信区间66.5 - 98.8），特异性为89%（可信区间60.4 - 97.8）。改良吉姆萨染色法的阳性预测值为93%（可信区间75 - 98.8%），阴性预测值为74%（可信区间48.6 - 89.9）。比较两种染色的kappa统计量为0.69（p值0.00001），表明两种测试之间具有良好的一致性。