幽门螺杆菌粪便抗原检测消化不良患者幽门螺杆菌感染的准确性。
Accuracy of Helicobacter pylori stool antigen for the detection of Helicobacter pylori infection in dyspeptic patients.
作者信息
Syam Ari Fahrial, Rani Abdul Aziz, Abdullah Murdani, Manan C, Makmun D, Simadibrata M, Djojoningrat D, Sato Tadashi
机构信息
Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Indonesia.
出版信息
World J Gastroenterol. 2005 Jan 21;11(3):386-8. doi: 10.3748/wjg.v11.i3.386.
AIM
The premier platinum Helicobacter pylori (H pylori) stool antigen (HpSA) test is an enzyme immunoassay (EIA) that detects an H pylori antigen present in human stools. However, at present there is no uniformity about the cut off level required to consider the test as positive or negative. So we need the cut off level for our local population. The aim of this study was to evaluate the HpSA for the detection of H pylori infection in dyspeptic patients and to determine the sensitivity, specificity of the HpSA test in the diagnosis of H pylori infection, as compared to other standardized diagnostic techniques.
METHODS
Sixty-three dyspeptic patients were selected from patients who came to the Division of Gastrointestinal Clinic in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. H pylori infection was confirmed in all patients by histology and rapid urease test (CLO test). Positive results for H pylori were based on positive results from both rapid urea test and microscopic detection of H pylori. Stool specimens were analyzed for H pylori antigen using HpSA immunoassay.
RESULTS
A total 63 patients consisted of 31 (49.2%) males and 32 (50.8%) females ranging in ages between 16 and 73 years with a mean age of 42.4+/-15 years. The mean age of men was 43.2+/-15.7 years and women was 41.6+/-14.4 years. Endoscopic findings in this study included gastric cancer 1.6%, peptic ulcer 4.8%, duodenal ulcer 7.9%, esophagitis 6.3%, gastritis 77.7%, and gastroduodenitis 4.8%. According to the predefined study criteria, 6 (9.5%) of 63 patients were positive for H pylori. In the diagnosis of infection, the area under the receiver operating characteristic (ROC) curve for the HpSA test was 0.722 (95% CI, 0.518-0.927). Using a cut-off value of 0.274 instead of 0.16 (as recommended by the manufacturer) the sensitivity and the specificity were 66.7% and 78.9% respectively.
CONCLUSION
The HpSA stool test, using a cut-off value of 0.274, may be useful for the primary diagnosis of H pylori infection, its specificity is similar to other standard tests but its sensitivity was lower.
目的
premier platinum幽门螺杆菌（Hp）粪便抗原（HpSA）检测是一种酶免疫测定法（EIA），用于检测人粪便中存在的幽门螺杆菌抗原。然而，目前对于将该检测判定为阳性或阴性所需的临界值尚无统一标准。因此，我们需要确定本地人群的临界值。本研究的目的是评估HpSA检测消化不良患者幽门螺杆菌感染的情况，并与其他标准化诊断技术相比，确定HpSA检测在诊断幽门螺杆菌感染中的敏感性和特异性。
方法
从印度尼西亚雅加达Cipto Mangunkusumo医院胃肠科门诊就诊的患者中选取63例消化不良患者。通过组织学和快速尿素酶试验（CLO试验）对所有患者的幽门螺杆菌感染进行确诊。幽门螺杆菌阳性结果基于快速尿素试验和幽门螺杆菌显微镜检测均为阳性。使用HpSA免疫测定法分析粪便标本中的幽门螺杆菌抗原。
结果
63例患者中，男性31例（49.2%），女性32例（50.8%），年龄在16至73岁之间，平均年龄为42.4±15岁。男性平均年龄为43.2±15.7岁，女性为41.6±14.4岁。本研究的内镜检查结果包括胃癌1.6%、消化性溃疡4.8%、十二指肠溃疡7.9%、食管炎6.3%、胃炎77.7%、胃十二指肠炎症4.8%。根据预先定义的研究标准，63例患者中有6例（9.5%）幽门螺杆菌检测呈阳性。在感染诊断中，HpSA检测的受试者操作特征（ROC）曲线下面积为0.722（95%CI，0.518 - 0.927）。使用0.274的临界值而非制造商推荐的0.16，敏感性和特异性分别为66.7%和78.9%。
结论
使用0.274临界值的HpSA粪便检测可能有助于幽门螺杆菌感染的初步诊断，其特异性与其他标准检测相似，但敏感性较低。
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