Paimela Hannu M, Oksala Niku K, Kääriäinen Ilpo P, Carlson Petteri J, Kostiala Anja A, Sipponen Pentti I
Department of Surgery, Helsinki University Central Hospital, Jorvi Hospital, Espoo, Finland.
Ann Med. 2006;38(5):352-6. doi: 10.1080/07853890600630567.
The frequent occurrence of Helicobacter pylori infection requires significant health care resources after eradication therapy. Therefore the non-invasive testing methods are required to alleviate the increased work-load of health care personnel and to allow an easy control of eradication therapy. Conventionally, the effect of eradication therapy has been confirmed with 13C-urea breath test 4-6 weeks after a completed eradication.
To assess the applicability of Helicobacter pylori stool antigen tests as alternatives to the breath test in the control of the effect of eradication therapy.
Fifty patients were diagnosed Helicobacter-positive by endoscopy and histology as well as by rapid urease test from mucosal specimen. Four weeks after an eradication therapy the patients were subjected to 13C-urea breath test as well as to faecal Helicobacter pylori antigen tests with mono- and polyclonal primary antibodies.
The monoclonal and polyclonal stool tests had 94% and 88% sensitivity, and 100% and 97% specificity, respectively, in the detection of Helicobacter pylori infection as compared to the 13C-urea breath test. The non-invasive test results were completely parallel in patients with various grades of mucosal atrophy or intestinal metaplasia.
Monoclonal faecal Helicobacter pylori antigen test is slightly superior to the polyclonal test regarding the sensitivity in the detection of stool Helicobacter antigens. Due to their sufficient sensitivity and specificity, and to their practicability and cost-effectiveness, they can be recommended for non-invasive testing of Helicobacter pylori infection as alternatives to the 13C-urea breath test.
幽门螺杆菌感染频繁发生，根除治疗后需要大量医疗资源。因此，需要非侵入性检测方法来减轻医护人员增加的工作量，并便于对根除治疗进行轻松监测。传统上，根除治疗的效果在完成根除后4 - 6周通过13C - 尿素呼气试验来确认。
评估幽门螺杆菌粪便抗原检测作为呼气试验替代方法在监测根除治疗效果中的适用性。
50例患者经内镜检查、组织学检查以及黏膜标本快速尿素酶试验诊断为幽门螺杆菌阳性。根除治疗4周后，患者接受13C - 尿素呼气试验以及使用单克隆和多克隆一抗的粪便幽门螺杆菌抗原检测。
与13C - 尿素呼气试验相比，单克隆和多克隆粪便检测在检测幽门螺杆菌感染时的敏感性分别为94%和88%，特异性分别为100%和97%。在不同程度黏膜萎缩或肠化生的患者中，非侵入性检测结果完全平行。
在检测粪便幽门螺杆菌抗原的敏感性方面，单克隆粪便幽门螺杆菌抗原检测略优于多克隆检测。由于其足够的敏感性和特异性，以及实用性和成本效益，它们可作为13C - 尿素呼气试验的替代方法，推荐用于幽门螺杆菌感染的非侵入性检测。
