Department of Hygiene and Epidemiology, University of Porto Medical School, Porto, Portugal.
BMC Gastroenterol. 2009 Dec 24;9:98. doi: 10.1186/1471-230X-9-98.
We aimed to provide empirical evidence of how spectrum effects can affect the sensitivity of histological assessment of Helicobacter pylori infection, which may contribute to explain the heterogeneity in prevalence estimates across populations with expectedly similar prevalence.
Cross-sectional evaluation of dyspeptic subjects undergoing upper digestive endoscopy, including collection of biopsy specimens from the greater curvature of the antrum for assessment of H. pylori infection by histopathological study and polymerase chain reaction (PCR), from Portugal (n = 106) and Mozambique (n = 102) following the same standardized protocol.
In the Portuguese sample the prevalence of infection was 95.3% by histological assessment and 98.1% by PCR. In the Mozambican sample the prevalence was 63.7% and 93.1%, respectively. Among those classified as infected by PCR, the sensitivity of histological assessment was 96.2% among the Portuguese and 66.3% among the Mozambican. Among those testing positive by both methods, 5.0% of the Portuguese and 20.6% of the Mozambican had mild density of colonization.
This study shows a lower sensitivity of histological assessment of H. pylori infection in Mozambican dyspeptic patients compared to the Portuguese, which may be explained by differences in the density of colonization, and may contribute to explain the heterogeneity in prevalence estimates across African settings.
我们旨在提供关于光谱效应如何影响幽门螺杆菌感染组织学评估敏感性的经验证据，这可能有助于解释预期具有相似流行率的人群中患病率估计的异质性。
对接受上消化道内镜检查的消化不良患者进行横断面评估，包括从胃窦大弯采集活检标本，通过组织病理学研究和聚合酶链反应（PCR）评估幽门螺杆菌感染，来自葡萄牙（n=106）和莫桑比克（n=102），遵循相同的标准化方案。
在葡萄牙样本中，组织学评估的感染率为 95.3%，PCR 为 98.1%。在莫桑比克样本中，感染率分别为 63.7%和 93.1%。在那些通过 PCR 分类为感染的人群中，组织学评估的敏感性在葡萄牙为 96.2%，在莫桑比克为 66.3%。在两种方法均呈阳性的人群中，5.0%的葡萄牙人和 20.6%的莫桑比克人存在轻度定植密度。
本研究表明，与葡萄牙相比，莫桑比克消化不良患者的幽门螺杆菌感染组织学评估敏感性较低，这可能是由于定植密度的差异所致，并可能有助于解释非洲人群中患病率估计的异质性。
