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快速尿素酶试验、触摸细胞学检查和组织病理学评估在门诊环境中确定幽门螺杆菌感染的应用

Rapid urease test, touch cytology and histopathologic assessment in determining infection by Helicobacter pylori in outpatient setting.

作者信息

Fakhrjou A, Somi M H, Fattahi E, Koohbanani S S, Shadravan S

机构信息

Department of Pathology, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Pak J Biol Sci. 2011 Jun 15;14(12):698-702. doi: 10.3923/pjbs.2011.698.702.

DOI:10.3923/pjbs.2011.698.702
PMID:22303644
Abstract

Helicobacterpylori (HP) is a common cause of gastric infection with serious consequences which is detected by different methods. This study aimed at comparing the diagnostic value of Rapid Urease Test (RUT), Touch Cytology (TC) and histopathologic assessment in outpatients setting. In this cross-sectional study, 51 candidates for upper gastrointestinal endoscopy were recruited in Tabriz Imam Khomeini Teaching Centre in a 24 month period of time. Three biopsy specimens were obtained from gastric antrum during endoscopic intervention. The RUT, TC and histopathologic assessment were performed on each biopsy specimen in each patient. Definite infection by HP was considered when at least 2 out of 3 tests indicated presence of infection. Fifty one patients, 29 females and 22 males with a mean age of 40.10 +/- 12.54 (range: 18-72) years enrolled in this study. Infection by HP was definite in 41 cases (80.4%). The infection rates by RUT, TC and histopathologic examination were 82.4, 82.4 and 76.5%, respectively. The sensitivity, specificity and accuracy of RUT, TC and histopathologic assessment were 92.7, 60 and 66.75%; 100, 90 and 98% and 95.1, 100 and 96.1%, respectively. There were significant agreements between outcomes of the three methods in diagnosis of infection by HP. In conclusion, TC was the most sensitive and histopathologic assessment was the most specific method in diagnosis of infection by HP in outpatient setting. The diagnostic value of RUT was rather low in this regard.

摘要

幽门螺杆菌(HP)是引起胃部感染的常见病因,会导致严重后果,可通过多种不同方法检测。本研究旨在比较快速尿素酶试验(RUT)、触摸细胞学检查(TC)和组织病理学评估在门诊环境中的诊断价值。在这项横断面研究中,24个月内招募了51名在大不里士伊玛目霍梅尼教学中心接受上消化道内镜检查的患者。在内镜检查过程中从胃窦获取了三份活检标本。对每位患者的每份活检标本都进行了RUT、TC和组织病理学评估。当三项检测中至少两项表明存在感染时,则判定为HP确诊感染。本研究纳入了51例患者,其中29例女性,22例男性,平均年龄为40.10±12.54岁(范围:18 - 72岁)。41例(80.4%)患者确诊为HP感染。RUT、TC和组织病理学检查的感染率分别为82.4%、82.4%和76.5%。RUT、TC和组织病理学评估的敏感性、特异性和准确性分别为92.7%、60%和66.75%;100%、90%和98%;以及95.1%、100%和96.1%。三种方法在诊断HP感染的结果之间存在显著一致性。总之,在门诊环境中,TC是诊断HP感染最敏感的方法,组织病理学评估是最具特异性的方法。在这方面,RUT的诊断价值相当低。

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