Tucci A, Tucci P, Bisceglia M, Marchegiani A, Papadopoli G, Fusaroli P, Spada A, Pistoletto M O, Pistoletto M O, Cristino M, Poli L, Villani A, Bucci M, Marinelli M, Caletti G
Gastrointestinal Unit, University of Bologna, AUSL of Imola, Castel S. Pietro Terme Hospital, Italy.
Endoscopy. 2005 Oct;37(10):966-76. doi: 10.1055/s-2005-870373.
Gastric juice may represent a valuable source of clinicopathological information if properly analyzed. We evaluated the reliability and clinical validity of data obtained using an innovative device (the "Mt 21-42") that analyzes gastric juice, thus allowing the identification of Helicobacter pylori infection and atrophic gastritis of the oxyntic mucosa during endoscopy.
Validation studies were carried out to evaluate the measuring performance of the device. In addition, the H. pylori status and the presence of atrophic gastritis were assessed in 150 patients undergoing upper gastrointestinal endoscopy. In all these patients the Mt 21-42 device was used to assist endoscopy. Conventional tests (involving histology, urease testing, urea breath testing, anti- H. pylori IgG, serum gastrin, pepsinogen, intrinsic factor and parietal cells autoantibodies, vitamin B12, and folate) were also performed for comparison with the Mt 21-42 results.
The measuring performance of the Mt 21-42 was good; for pH, the relative percent error and the coefficient of variation were 1.9 % +/- 4.2 and 1.3 %, respectively, and for ammonium they were 0.1 % +/- 0.2 % and 2.1 %. For the detection of H. pylori infection, the sensitivity and specificity of the device (96.7 % and 94.3 %) were similar to those of the urea breath test (90.5 % and 93.3 %) and serology (87.1 % and 88.8 %), and higher than those of the urease test (78.6 % and 98.7 %; P < 0.01) and routine histology (94.3 % and 76.3 %; P < 0.05). When compared with the currently available standard methods, use of the Mt 21-42 was found to be the most sensitive technique for the detection of atrophy (94.7 % vs. 5.3 % - 47.4 %; P < 0.001); the device failed to detect the disease in only one case (5 %), whereas failure rates of 53 % - 95 % were reported with the conventional methods.
Atrophic gastritis of the oxyntic mucosa is a risky condition that often goes undetected in current clinical practice. The Mt 21-42 is an effective, useful, and desirable tool that may help to overcome this diagnostic limitation; it produces time and cost savings and also allows the detection of H. pylori infection.
如果分析得当，胃液可能是临床病理信息的宝贵来源。我们评估了使用一种创新设备（“Mt 21 - 42”）获取的数据的可靠性和临床有效性，该设备可分析胃液，从而在内镜检查期间识别幽门螺杆菌感染和胃体黏膜萎缩性胃炎。
进行了验证研究以评估该设备的测量性能。此外，对150例接受上消化道内镜检查的患者评估了幽门螺杆菌状态和萎缩性胃炎的存在情况。在所有这些患者中，使用Mt 21 - 42设备辅助内镜检查。还进行了常规检测（包括组织学、尿素酶检测、尿素呼气试验、抗幽门螺杆菌IgG、血清胃泌素、胃蛋白酶原、内因子和壁细胞自身抗体、维生素B12和叶酸）以与Mt 21 - 42的结果进行比较。
Mt 21 - 42的测量性能良好；对于pH值，相对百分比误差和变异系数分别为1.9%±4.2%和1.3%，对于铵，分别为0.1%±0.2%和2.1%。对于幽门螺杆菌感染的检测，该设备的敏感性和特异性（96.7%和94.3%）与尿素呼气试验（90.5%和93.3%）和血清学（87.1%和88.8%）相似，且高于尿素酶试验（78.6%和98.7%；P < 0.01）和常规组织学（94.3%和76.3%；P < 0.05）。与目前可用的标准方法相比，发现使用Mt 21 - 42是检测萎缩最敏感的技术（94.7%对5.3% - 47.4%；P < 0.001）；该设备仅在1例（5%）中未能检测到该病，而常规方法的漏检率为53% - 95%。
胃体黏膜萎缩性胃炎是一种在当前临床实践中常被漏诊的危险病症。Mt 21 - 42是一种有效、有用且理想的工具，可能有助于克服这一诊断局限性；它节省时间和成本，还能检测幽门螺杆菌感染。
