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[快速尿素酶试验与病理组织学胃活检结果及免疫检测阳性在检测幽门螺杆菌感染中的相关性]

[Correlation between rapid urease test and pathohistological gastrobiopsy finding with positive immunological test in detecting Helicobacter pylori infection].

作者信息

Naumov Ivana, Fenjvesi Atila

机构信息

Sluzba za unutrasnje bolesti, Opsta bolnica "Dr Gere Istvan", Senta.

出版信息

Med Pregl. 2011 Jul-Aug;64(7-8):413-7. doi: 10.2298/mpns1108413n.

Abstract

INTRODUCTION

Helicobacter pylori is a bacterium that has been in the limelight of gastroenterologists and oncologists worldwide since its immediate effect on the development of gastritis, ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer was proved. The aim of this study was to determine the correlation between the positive immunological test, rapid urease test and pathohistological finding in detecting Helicobacter pylori infection of the gastric mucosa.

MATERIAL AND METHODS

This retrospective study included 250 endoscopic findings of subjects having undergone endoscopy in the first half of 2010 at the Ward of Gastroenterology, Department of Internal Diseases, Hospital in Senta. The endoscopy procedure was performed by Fujinon endoscopes and the fast urease test was done by the Cambridge Life Science set from England. The immunological test was carried out by the Vidas apparatus applying the Enzyme-Linked Fluorescent Assay (ELFA) technique and the staining for the pathohistological analysis was done by the modified Giemsa method.

RESULTS

The paper presents the results obtained by endoscopic examination of a group of 250 patients performed at the Ward of Gastroenterology, Department of Internal Diseases, Hospital in Senta. The endoscopic findings were the first to be analyzed then the rapid urease test findings, which showed that 95 (38%) patients were positive and 155 (62%) patients were negative; whereas the immunologic test for Helicobacter pylori was positive in all 250 patients (100%). The histological test for Helicobacter-Like Organism was positive in 105 subjects (42%), whereas it was negative in 145 patients, that being 58% of all the cases. Sensitivity, specificity and predictability of the serological test and the rapid urease test were calculated according to the pathohistological finding as the "gold standard" and they were found to be: sensitivity 100% and specificity 0% for the serological test and sensitivity 90% and specificity 100% for the rapid urease test. The immunologic test was not correlated with other findings, and there was a high level of correlation between the rapid urease test and histological test (r = 0.927589261). The t-test was calculated to be 36.16513; p = 0.0001; that indicating that the correlation coefficient was statistically significant (p > 0.01).

DISCUSSION

The obtained results were compared with the data found in the available literature sources.

CONCLUSION

It can be concluded that the most competent technique for the optimal diagnosis of Helicobacter pylori infection is the invasive one with the pathohistological examination of bioptates together with the rapid urease test.

摘要

引言

自幽门螺杆菌对胃炎、溃疡病、黏膜相关淋巴组织淋巴瘤和胃癌的发生发展具有直接影响得到证实以来,它一直是全球胃肠病学家和肿瘤学家关注的焦点。本研究的目的是确定在检测胃黏膜幽门螺杆菌感染时,免疫检测阳性、快速尿素酶试验与病理组织学检查结果之间的相关性。

材料与方法

这项回顾性研究纳入了2010年上半年在森塔医院内科胃肠病病房接受内镜检查的250例患者的内镜检查结果。内镜检查使用富士能内镜进行,快速尿素酶试验采用英国剑桥生命科学公司的试剂盒。免疫检测使用Vidas仪器,采用酶联荧光分析(ELFA)技术,病理组织学分析的染色采用改良吉姆萨法。

结果

本文展示了在森塔医院内科胃肠病病房对一组250例患者进行内镜检查所获得的结果。首先分析内镜检查结果,然后是快速尿素酶试验结果,结果显示95例(38%)患者为阳性,155例(62%)患者为阴性;而幽门螺杆菌免疫检测在所有250例患者中均为阳性(100%)。幽门螺杆菌样生物体的组织学检测在105例受试者中为阳性(42%),而在145例患者中为阴性,占所有病例的58%。以病理组织学检查结果作为“金标准”,计算血清学检测和快速尿素酶试验的敏感性、特异性和预测性,结果发现:血清学检测的敏感性为100%,特异性为0%;快速尿素酶试验的敏感性为90%,特异性为100%。免疫检测与其他结果无相关性,快速尿素酶试验与组织学检测之间存在高度相关性(r = 0.927589261)。t检验计算值为36.16513;p = 0.0001;这表明相关系数具有统计学意义(p > 0.01)。

讨论

将获得的结果与现有文献资料中的数据进行了比较。

结论

可以得出结论,对于幽门螺杆菌感染的最佳诊断,最有效的技术是对活检组织进行病理组织学检查并结合快速尿素酶试验的侵入性方法。

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