Ito Masanori, Tanaka Shinji, Kim Sunjin, Tahara Kazumasa, Kawamura Yuzuru, Sumii Masaharu, Takehara Yoshihiko, Hayashi Kozo, Okamoto Eiichi, Kunihiro Masaki, Kunita Toshiro, Imagawa Shinobu, Takata Shunsuke, Ueda Hiroyuki, Egi Yasuo, Hiyama Toru, Ueno Yoshitaka, Kitadai Yasuhiko, Yoshihara Masaharu, Chayama Kazuaki
Department of Medicine and Molecular Science, Hirsohima University, Hiroshima 734-8551, Japan.
J Gastroenterol Hepatol. 2005 Aug;20(8):1241-5. doi: 10.1111/j.1440-1746.2005.03928.x.
Helicobacter pylori stool antigen (HpSA) test is a new tool for evaluating the H. pylori infection. The present study was carried out to investigate the clinical usefulness of the HpSA test in the evaluation of eradication therapy by comparing it with the (13)C-urea breath test (UBT).
One hundred and five patients received eradication therapy for H. pylori. After more than 8 weeks, the success of the therapy was evaluated by the HpSA test and the UBT. Concordant results were regarded as a final diagnosis, but when the results were discordant, histological examination was carried out.
Of the 105 patients receiving eradication therapy for H. pylori, 25 patients were regarded as H. pylori positive by the UBT and and 20 patients were regarded as H. pylori positive by the the HpSA test. Nine patients (8.6%) showed discordant results (seven cases with UBT(+) and HpSA(-), and two with UBT(-) and HpSA(+)). Five cases out of nine were ultimately judged as having a false-positive result of the UBT, and in these cases the UBT values were relatively low (below 10 per thousand). The final diagnostic accuracies of the UBT and the HpSA test were 94.3% (88.0-97.9%; 95% CI) and 97.1% (91.9-99.4%), respectively. When we used the HpSA test in cases with weakly positive UBT values, we were able to diagnose the correct status of H. pylori infection after eradication in 99% of all patients (94.8-100.0%).
The HpSA test is a useful tool for the evaluation of eradication therapy and a combination of the HpSA test and UBT is clinically recommended.
幽门螺杆菌粪便抗原（HpSA）检测是评估幽门螺杆菌感染的一种新工具。本研究旨在通过将HpSA检测与（13）C-尿素呼气试验（UBT）进行比较，探讨HpSA检测在评估根除治疗中的临床实用性。
105例患者接受了幽门螺杆菌根除治疗。8周多后，通过HpSA检测和UBT评估治疗效果。结果一致被视为最终诊断，但结果不一致时，则进行组织学检查。
在105例接受幽门螺杆菌根除治疗的患者中，UBT检测认为25例患者幽门螺杆菌阳性，HpSA检测认为20例患者幽门螺杆菌阳性。9例患者（8.6%）结果不一致（7例UBT（+）且HpSA（-），2例UBT（-）且HpSA（+））。9例中有5例最终被判定为UBT假阳性，这些病例中UBT值相对较低（低于千分之10）。UBT和HpSA检测的最终诊断准确率分别为94.3%（88.0-97.9%；95%CI）和97.1%（91.9-99.4%）。当我们在UBT值弱阳性的病例中使用HpSA检测时，我们能够在99%的所有患者（94.8-100.0%）中诊断出根除治疗后幽门螺杆菌感染的正确状态。
HpSA检测是评估根除治疗的有用工具，临床上推荐将HpSA检测和UBT联合使用。
