使用EndoFaster在临床实践中优化幽门螺杆菌的检测。

Optimizing the searching for H. pylori in clinical practice with EndoFaster.

作者信息

Zullo Angelo, Germanà Bastianello, Galliani Ermenegildo, Iori Andrea, de Pretis Giovanni, Manfredi Guido, Buscarini Elisabetta, Buonocore Matteo Rossano, Monica Fabio

机构信息

Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Via Emilio Morosini, 30, Rome 00153, Italy.

Gastroenterology Unit, 'San Martino' Hospital, Belluno, Italy.

出版信息

Dig Liver Dis. 2021 Jun;53(6):772-775. doi: 10.1016/j.dld.2021.02.004. Epub 2021 Mar 3.

DOI:10.1016/j.dld.2021.02.004

PMID:33676857

Abstract

BACKGROUND/AIM: H. pylori plays a major role in gastroduodenal diseases. Since its incidence is decreasing in developed countries, gastric biopsies were negative in several patients managed in clinical practice. We tested whether EndoFaster - a device allowing real-time H. pylori detection by gastric juice analysis - may optimize the need of biopsies.

METHODS

In this prospective, multicentre study, the accuracy of EndoFaster for H. pylori detection was computed by using histology of gastric biopsies as a gold standard.

RESULTS

Data of 525 consecutive patients were available, including 90 (17.1%) patients with infection. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of EndoFaster were 87%, 84%, 53%, 97% and 85%, respectively. The overall accuracy of test was not affected neither by ongoing proton pump inhibitor therapy nor by previous eradication therapy. By using EndoFaster in our series, biopsy sampling could have been eventually avoided in a total of 279 patients, accounting for a reduction of 42.3%, accepting the risk of only 8 false negative cases.

CONCLUSIONS

The very high NPV of EndoFaster might allow to safely halve the need of taking gastric biopsies in unselected patients managed in clinical practice, avoiding an unavailing consume of health resources.

摘要

背景/目的：幽门螺杆菌在胃十二指肠疾病中起主要作用。由于其在发达国家的发病率正在下降，在临床实践中管理的一些患者的胃活检结果为阴性。我们测试了EndoFaster（一种通过胃液分析进行实时幽门螺杆菌检测的设备）是否可以优化活检需求。

方法

在这项前瞻性多中心研究中，以胃活检组织学为金标准计算EndoFaster检测幽门螺杆菌的准确性。

结果

获得了525例连续患者的数据，其中90例（17.1%）患者感染。EndoFaster的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和总体准确性分别为87%、84%、53%、97%和85%。检测的总体准确性不受正在进行的质子泵抑制剂治疗或先前根除治疗的影响。在我们的系列研究中使用EndoFaster，最终可以避免总共279例患者进行活检采样，占比降低42.3%，仅接受8例假阴性病例的风险。