Medical Department ІІ, University Hospital LMU Munich, Munich 81377, Germany.
Deutsches Zentrum für Infektionsforschung, Partner Site Munich, Munich 81377, Germany.
World J Gastroenterol. 2023 Mar 14;29(10):1638-1647. doi: 10.3748/wjg.v29.i10.1638.
Endofaster is an innovative technology that can be combined with upper gastrointestinal endoscopy (UGE) to perform gastric juice analysis and real-time detection of ().
To assess the diagnostic performance of this technology and its impact on the management of in the real-life clinical setting.
Patients undergoing routine UGE were prospectively recruited. Biopsies were taken to assess gastric histology according to the updated Sydney system and for rapid urease test (RUT). Gastric juice sampling and analysis was performed using the Endofaster, and the diagnosis of was based on real-time ammonium measurements. Histological detection of served as the diagnostic gold standard for comparing Endofaster-based diagnosis with RUT-based detection.
A total of 198 patients were prospectively enrolled in an diagnostic study by Endofaster-based gastric juice analysis (EGJA) during the UGE. Biopsies for RUT and histological assessment were performed on 161 patients (82 men and 79 women, mean age 54.8 ± 19.2 years). infection was detected by histology in 47 (29.2%) patients. Overall, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value (NPV) for diagnosis by EGJA were 91.5%, 93.0%, 92.6%, 84.3%, and 96.4%, respectively. In patients on treatment with proton pump inhibitors, diagnostic sensitivity was reduced by 27.3%, while specificity and NPV were unaffected. EGJA and RUT were comparable in diagnostic performance and highly concordant in detection (κ-value = 0.85).
Endofaster allows for rapid and highly accurate detection of during gastroscopy. This may guide taking additional biopsies for antibiotic susceptibility testing during the same procedure and then selecting an individually tailored eradication regimen.
Endofaster 是一种创新技术，可与上消化道内镜 (UGE) 结合使用，进行胃液分析和实时检测 ( )。
评估该技术的诊断性能及其在真实临床环境中对 的管理的影响。
前瞻性招募接受常规 UGE 的患者。根据更新的悉尼系统进行活检以评估胃组织学，并进行快速尿素酶试验 (RUT)。使用 Endofaster 进行胃液采样和分析，根据实时铵测量诊断 。组织学检测 作为比较 Endofaster 基于 的诊断与 RUT 基于 的检测的诊断金标准。
共前瞻性纳入 198 例接受基于 Endofaster 的胃液分析 (EGJA) 的 UGE 诊断研究的患者。对 161 例患者（82 名男性和 79 名女性，平均年龄 54.8 ± 19.2 岁）进行了 RUT 和组织学评估的活检。组织学检测到 47 例（29.2%）患者感染。总体而言，EGJA 对 的诊断的敏感性、特异性、准确性、阳性预测值和阴性预测值（NPV）分别为 91.5%、93.0%、92.6%、84.3%和 96.4%。在接受质子泵抑制剂治疗的患者中，诊断敏感性降低了 27.3%，而特异性和 NPV 不受影响。EGJA 和 RUT 在诊断性能方面相当，在 检测方面高度一致（κ 值=0.85）。
Endofaster 可在胃镜检查期间快速且高度准确地检测 。这可能有助于在同一程序中进行额外的活检以进行抗生素药敏试验，然后选择个体化的根除方案。
