Bazin Thomas, Nchare Mfondi Arouna, Julie Catherine, Émile Jean-François, Raymond Josette, Lamarque Dominique
Université de Bordeaux, INRA, EA 3671, CHU Bordeaux, Bordeaux, France.
Yaounde Emergency Center, Yaounde Hospital, Yaounde Hospital, Cameroon.
United European Gastroenterol J. 2018 Oct;6(8):1267-1273. doi: 10.1177/2050640618787055. Epub 2018 Jun 27.
detection by standard methods may be altered by proton pump inhibitor (PPI) use. However, some patients cannot or should not interrupt PPI use before undergoing testing for . Polymerase chain reaction (PCR) could allow more reliable detection even in patients taking PPIs.
The aim of our study is to compare the infection diagnostic value of histological examination without and with immunohistochemical staining, bacterial culture and PCR, in PPI-treated vs untreated patients.
Patients undergoing a gastric endoscopy for upper digestive symptoms were included. Gastric biopsy samples were obtained. The impact of taking PPI on the diagnostic performance of the different methods was studied. PCR results were confirmed by sequencing the gene.
A total of 497 patients were included, of whom 192 were positive. Fifty-two patients received PPIs during the 14 days preceding the endoscopy while 140 did not. All methods had lower sensitivity than PCR, in all cases (PPI treatment or not). PPI use did not change significantly the methods' sensitivities.
The PCR method showed the best performance for the detection of in gastric samples, whether or not patients received previous PPI treatment. This diagnosis test could become a new gold-standard test, especially in patients undergoing PPI treatment.
质子泵抑制剂（PPI）的使用可能会改变标准方法的检测结果。然而，一些患者在接受检测前不能或不应中断PPI的使用。聚合酶链反应（PCR）即使在服用PPI的患者中也能实现更可靠的检测。
我们研究的目的是比较在接受PPI治疗和未接受PPI治疗的患者中，组织学检查（有无免疫组化染色）、细菌培养和PCR对幽门螺杆菌感染的诊断价值。
纳入因上消化道症状接受胃镜检查的患者。获取胃活检样本。研究服用PPI对不同方法诊断性能的影响。通过对幽门螺杆菌基因测序来确认PCR结果。
共纳入497例患者，其中192例幽门螺杆菌阳性。52例患者在胃镜检查前14天内服用了PPI，140例未服用。在所有情况下（无论是否接受PPI治疗），所有方法的敏感性均低于PCR。PPI的使用并未显著改变这些方法的敏感性。
无论患者之前是否接受PPI治疗，PCR方法在检测胃样本中的幽门螺杆菌方面表现最佳。这种诊断测试可能会成为一种新的金标准测试，尤其是在接受PPI治疗的患者中。
