Miura Mika, Ohtaka Masahiko, Hanawa Mitsuhiko, Kitahashi Atsuko, Hirose Yuichi, Takaso Kazuhiko, Yoda Yoshioki, Takayama Ichiro, Yamagata Zentarou, Enomoto Nobuyuki
Yamanashi Koseiren Health Care Center.
First Department of Internal Medicine, Graduate School of Medical and Engineering Science, University of Yamanashi.
Nihon Shokakibyo Gakkai Zasshi. 2018;115(8):721-731. doi: 10.11405/nisshoshi.115.721.
The LZ test "Eiken" for H. pylori antibody (LZ test) was examined. In patients with an antibody titer of ≥3.0U/mL and <10.0U/mL among 698 patients who underwent breath tests, the status of H. pylori infection was assessed from the results of the C urea breath test and the findings of gastric mucosal atrophy by performing an upper gastrointestinal endoscopy. A positive C urea breath test was observed in 22.3% of these patients (156/698, 95% confidence interval 19.4-25.6%), and gastric mucosal atrophy of C-2 or greater was observed in 39.7%. We presumed that 156 (22.3%) patients had present H. pylori infections, 141 (20.2%) patients had experienced a previous infection, and 401 (57.5%) patients were uninfected. The infection rate of H. pylori (current infection+previous infection) was treated as a so-called "risk of gastric cancer" and was 42.6% (297/698, 95% confidence interval 38.9-46.3%). In the LZ test, the concept of a negative high value should be understood. A receiver operating characteristic curve plotted depending on whether the C urea breath test was positive or not gave a positive cutoff value of 5.6U/mL;values greater than the cutoff value were taken as indicative of the need to investigate the status of H. pylori infection. Even without gastric mucosal atrophy, 2.0% of these patients had a positive breath test. For gastritis localized in the antrum (C-1), 17.8% of the patients had positive breath test results.
对用于检测幽门螺杆菌抗体的LZ检测“荣研”法(LZ检测)进行了研究。在698例接受呼气试验的患者中,抗体滴度≥3.0U/mL且<10.0U/mL的患者,通过碳尿素呼气试验结果和上消化道内镜检查的胃黏膜萎缩情况来评估幽门螺杆菌感染状态。这些患者中22.3%(156/698,95%置信区间19.4 - 25.6%)碳尿素呼气试验呈阳性,39.7%观察到C-2级或更严重的胃黏膜萎缩。我们推测156例(22.3%)患者目前有幽门螺杆菌感染,141例(20.2%)患者曾有过感染,401例(57.5%)患者未感染。幽门螺杆菌感染率(现感染+既往感染)被视为所谓的“胃癌风险”,为42.6%(297/698,95%置信区间38.9 - 46.3%)。在LZ检测中,应理解阴性高值的概念。根据碳尿素呼气试验是否为阳性绘制的受试者工作特征曲线得出阳性临界值为5.6U/mL;大于临界值的值被视为表明需要调查幽门螺杆菌感染状态。即使没有胃黏膜萎缩,这些患者中有2.0%呼气试验呈阳性。对于局限于胃窦的胃炎(C-1),17.8%的患者呼气试验结果为阳性。