Treepongkaruna Suporn, Nopchinda Supujchara, Taweewongsounton Aruchalean, Atisook Kanit, Pienvichit Paneeya, Vithayasai Niyada, Simakachorn Nipat, Aanpreung Prapun
Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Trop Pediatr. 2006 Aug;52(4):267-71. doi: 10.1093/tropej/fmk003. Epub 2006 Jan 9.
The gold standard for the diagnosis of Helicobacter pylori infection requires an endoscopic biopsy of gastric mucosa for histological examination, urease test and culture. Noninvasive serological tests are useful as a screening test for H. pylori infection. The aim of this study was to evaluate the performance of a rapid office-based serologic test, using immunochromatography ICM, and the immunoblotting for the diagnosis of H. pylori infection in Thai children. Eighty-two symptomatic children, 30 boys and 52 girls (mean age 9.2+/-3.8 years; range, 1.2-16.0 years) who had no previous treatment for H. pylori underwent upper endoscopy. Biopsies were obtained from the gastric body and antrum for histopathology and rapid urease test. Serum samples collected from all patients were tested for H. pylori IgG antibodies using ICM (Assure H. pylori Rapid Test, Genelabs Diagnostics, Singapore). Immunoblotting (HelicoBlot 2.1, Genelabs Diagnostics, Singapore) was tested in sera of 75 patients to detect antibodies to specific antigens of H. pylori. Positive H. pylori status was defined as positive for both histology and rapid urease test. Of 82 patients, 25 (30.5%) were H. pylori positive, 56 (68.3%) were H. pylori negative and one was equivocal. ICM assay yielded a positive result in 24 of the 25 H. pylori-positive patients (96.0%) and 3 of the 56 H. pylori-negative patients (5.4%). The immunoblotting yielded a positive result in all of 22 H. pylori-positive patients (100%) and in 2 of the 52 H. pylori-negative patients (3.8%). Obtained ICM's sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 96.0, 94.6, 88.9, 98.1 and 95.1%, with immunoblotting 100.0, 96.2, 91.6, 100.0, and 97.3%, respectively. The immunochromatographic and immunoblot tests are non-invasive, reliable and useful for the diagnosis of H. pylori infection in Thai children.
幽门螺杆菌感染诊断的金标准需要对胃黏膜进行内镜活检以进行组织学检查、尿素酶试验和培养。非侵入性血清学检测作为幽门螺杆菌感染的筛查试验很有用。本研究的目的是评估一种基于办公室的快速血清学检测方法，即使用免疫层析法（ICM）和免疫印迹法在泰国儿童中诊断幽门螺杆菌感染的性能。82名有症状的儿童，30名男孩和52名女孩（平均年龄9.2±3.8岁；范围1.2 - 16.0岁），之前未接受过幽门螺杆菌治疗，接受了上消化道内镜检查。从胃体和胃窦获取活检组织用于组织病理学检查和快速尿素酶试验。从所有患者采集的血清样本使用ICM（Assure H. pylori Rapid Test，新加坡基因实验室诊断公司）检测幽门螺杆菌IgG抗体。对75名患者的血清进行免疫印迹法（HelicoBlot 2.1，新加坡基因实验室诊断公司）检测，以检测针对幽门螺杆菌特定抗原的抗体。幽门螺杆菌阳性状态定义为组织学检查和快速尿素酶试验均为阳性。82名患者中，25名（30.5%）幽门螺杆菌阳性，56名（68.3%）幽门螺杆菌阴性，1名结果不明确。ICM检测在25名幽门螺杆菌阳性患者中的24名（96.0%）和56名幽门螺杆菌阴性患者中的3名（5.4%）产生了阳性结果。免疫印迹法在22名幽门螺杆菌阳性患者中的所有患者（100%）和52名幽门螺杆菌阴性患者中的2名（3.8%）产生了阳性结果。ICM的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为96.0%、94.6%、88.9%、98.1%和95.1%，免疫印迹法分别为100.0%、96.2%、91.6%、100.0%和97.3%。免疫层析和免疫印迹检测对于泰国儿童幽门螺杆菌感染的诊断是非侵入性、可靠且有用的。
