Kalem Fatma, Ozdemir Mehmet, Baysal Bülent
Konya Numune Hastanesi, Klinik Mikrobiyoloji Laboratuvan, Konya.
Mikrobiyol Bul. 2010 Jan;44(1):29-34.
Helicobacter pylori infections which are common worldwide may be a risk factor for gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphomas. For the detection of H. pylori, invasive methods such as culture, histopathology and rapid urease tests which require endoscopy and gastric biopsy specimen and non-invasive methods (not requiring endoscopy) such as urea breath test, stool antigen test (H. pylori stool antigen; HpSA) and serology are used. The aim of this study was to investigate the presence of H. pylori in patients with dyspeptic complaints, by rapid urease test, HpSA test, culture and histopathology and to evaluate the diagnostic performance of HpSA test. A total of 103 dyspeptic patients who were admitted to Selcuk University Meram Medical Faculty Gastroenterology Clinic and undergone gastroduodenal endoscopy between January 2005 and December 2006, were included to the study. All the specimens were cultivated, however, urease activity was tested in 98 of the patients, histopathological examination in 76 and HpSA test in 86 of the patients. H. pylori was isolated in 38.8% (40/103) of the specimens by culture. H. pylori was positive in 38.2% (29/76) of the specimens by histopathology, in 86.7% (85/98) by urease test, and in 44.2% (38/86) by HpSA test. The sensitivity and specificity values of the tests when culture was taken as the gold standard, were; 97.5% and 20.7% for urease test, 75% and 82.6% for HpSA test and 72.5% and 100% for histopathology, respectively. In conclusion, HpSA method could be applied as a screening test for H. pylori diagnosis in case endoscopy could not be performed. However, if invasive methods were to be performed, the diagnosis should be confirmed by a more sensitive and specific test such as culture and histopathology.
幽门螺杆菌感染在全球范围内都很常见，它可能是胃炎、胃和十二指肠溃疡、胃腺癌以及黏膜相关淋巴组织（MALT）淋巴瘤的一个风险因素。对于幽门螺杆菌的检测，采用了侵入性方法，如培养、组织病理学检查和快速尿素酶试验，这些方法需要进行内镜检查和胃活检标本，以及非侵入性方法（无需内镜检查），如尿素呼气试验、粪便抗原检测（幽门螺杆菌粪便抗原；HpSA）和血清学检测。本研究的目的是通过快速尿素酶试验、HpSA检测、培养和组织病理学检查来调查有消化不良症状患者中幽门螺杆菌的存在情况，并评估HpSA检测的诊断性能。共有103例有消化不良症状的患者被纳入该研究，这些患者于2005年1月至2006年12月期间入住塞尔丘克大学梅拉姆医学院胃肠病学诊所并接受了胃十二指肠内镜检查。所有标本均进行了培养，然而，对98例患者进行了尿素酶活性检测，76例进行了组织病理学检查，86例进行了HpSA检测。通过培养，在38.8%（40/103）的标本中分离出幽门螺杆菌。通过组织病理学检查，在38.2%（29/76）的标本中幽门螺杆菌呈阳性，通过尿素酶试验在86.7%（85/98）的标本中呈阳性，通过HpSA检测在44.2%（38/86）的标本中呈阳性。以培养作为金标准时，各检测方法的敏感性和特异性值分别为：尿素酶试验为97.5%和20.7%，HpSA检测为75%和82.6%，组织病理学检查为72.5%和100%。总之，如果无法进行内镜检查，HpSA方法可作为幽门螺杆菌诊断的筛查试验应用。然而，如果要采用侵入性方法，诊断应通过更敏感和特异的检测方法，如培养和组织病理学检查来确认。
