Trevisani Lucio, Simone Loredana, Matarese Vincenzo, Cifalà Viviana, Sartori Sergio, Abbasciano Vincenzo
Centro di Endoscopia Digestiva, Dipartimento di Medicina, Azienda Ospedaliera-Universitaria Arcispedale S. Anna, Ferrara.
Recenti Prog Med. 2005 Jun;96(6):271-7.
Since Helicobacter pylori (H. pylori) infection was recognized as a major cause of peptic ulcer disease and an important risk factor for gastric malignancy, several strategies have been used to diagnose it. These methods are split up along two lines: 1) direct detection of the bacteria, and 2) detection of antigen-antibody assay against H. pylori, or anyhow detection of H. pylori by indirect methods. In this review of literature about the methods to diagnose H. pylori infection, we focused in particular on the non-invasive tests based on H. pylori antigens detection in faeces. Some meta-analyses showed that immunoenzymatic stool tests can be considered reliable in untreated patients, whereas further confirmations are needed before extending their use also in anti-H. pylori treated patients. As it concerns cost-analysis, immunoenzymatic stool test is the most cost-effective among the tests today available. Finally, a newly developed office-based stool test has been evaluated. It does not require laboratory assay, and the results are available within 10 minutes. Preliminary data about its clinical usefulness are promising, but further and wider confirmations are needed, as it has been put on the market quite recently.
自从幽门螺杆菌(H. pylori)感染被认为是消化性溃疡疾病的主要病因以及胃癌的重要危险因素以来,人们已经采用了多种策略来诊断它。这些方法可分为两类:1)直接检测细菌;2)检测针对幽门螺杆菌的抗原-抗体检测,或者通过间接方法检测幽门螺杆菌。在这篇关于幽门螺杆菌感染诊断方法的文献综述中,我们特别关注基于粪便中幽门螺杆菌抗原检测的非侵入性检测。一些荟萃分析表明,免疫酶粪便检测在未治疗的患者中可被认为是可靠的,而在将其应用扩展到抗幽门螺杆菌治疗的患者之前,还需要进一步证实。就成本分析而言,免疫酶粪便检测是目前可用检测中最具成本效益的。最后,一种新开发的门诊粪便检测已经过评估。它不需要实验室检测,10分钟内即可出结果。关于其临床实用性的初步数据很有前景,但由于它最近才投放市场,还需要进一步更广泛的证实。