Rupp Sebastian, Papaefthymiou Apostolis, Chatzimichael Eleftherios, Polyzos Stergios A, Spreitzer Stefan, Doulberis Michael, Kuntzen Thomas, Kountouras Jannis
Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Switzerland (Sebastian Rupp, Michael Doulberis, Thomas Kuntzen).
Department of Gastroenterology, University Hospital of Larissa, Greece (Apostolis Papaefthymiou).
Ann Gastroenterol. 2022 Jul-Aug;35(4):333-344. doi: 10.20524/aog.2022.0725. Epub 2022 Jun 2.
() is a causative agent of peptic ulcer disease and plays an important role in the development of various other upper and lower gastrointestinal tract and systemic diseases; in addition to carcinogenesis and the development of mucosa-associated lymphoid tissue lymphoma, extragastric manifestations of are increasingly being unraveled. Therefore, prompt and accurate diagnosis is essential. Within this narrative review we present an overview of the current trend in the diagnosis of infection and its potential oncogenic sequelae, including gastric mucosa atrophy, intestinal metaplasia, dysplasia and gastric cancer. Signs of -related gastric cancer risk can be assessed by endoscopy using the Kyoto classification score. New technology, such as optical or digital chromoendoscopy, improves diagnostic accuracy and provides information regarding -related gastric preneoplastic and malignant lesions. In addition, a rapid urease test or histological examination should be performed, as these offer a high diagnostic sensitivity; both are also useful for the diagnosis of sequelae including gastric and colon neoplasms. Culture is necessary for resistance testing and detecting -related gastric dysbiosis involved in gastric oncogenesis. Likewise, molecular methods can be utilized for resistance testing and detecting -related gastric cancer development and progression. Noninvasive tests, such as the urea breath and stool antigen tests, can also be implemented; these are also suitable for monitoring eradication success and possibly for detecting -related gastric malignancy. Serological tests may help to exclude infection in specific populations and detect gastric and colon cancers. Finally, there are emerging potential diagnostic biomarkers for -related gastric cancer.
（）是消化性溃疡病的病原体，在各种其他上、下消化道及全身性疾病的发生发展中起重要作用；除致癌作用和黏膜相关淋巴组织淋巴瘤的发生外，（）的胃外表现也越来越多地被揭示出来。因此，及时准确的诊断至关重要。在这篇叙述性综述中，我们概述了（）感染诊断的当前趋势及其潜在的致癌后遗症，包括胃黏膜萎缩、肠化生、发育异常和胃癌。与（）相关的胃癌风险迹象可通过内镜检查使用京都分类评分进行评估。新技术，如光学或数字染色内镜检查，可提高诊断准确性，并提供有关与（）相关的胃肿瘤前病变和恶性病变的信息。此外，应进行快速尿素酶试验或组织学检查，因为这些检查具有较高的诊断敏感性；两者对包括胃和结肠肿瘤在内的后遗症诊断也很有用。培养对于耐药性检测和检测参与胃癌发生的与（）相关的胃生态失调是必要的。同样，分子方法可用于耐药性检测以及检测与（）相关的胃癌发生和进展。非侵入性检测，如尿素呼气试验和粪便抗原试验，也可实施；这些检测也适用于监测根除成功情况，可能还适用于检测与（）相关的胃恶性肿瘤。血清学检测可能有助于在特定人群中排除感染，并检测胃癌和结肠癌。最后，出现了与（）相关胃癌的潜在诊断生物标志物。
