Kabir Ali, Abdolhosseini Shahrbanoo, Zare-Mirzaei Ali, Pazouki Abdolreza, Masoodi Mohsen, Agah Shahram, Faghihi Kashani Amirhossein
Minimally Invasive Surgery Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2024 Feb 7;38:13. doi: 10.47176/mjiri.38.13. eCollection 2024.
Obesity and () infection are public health problems in the world and Iran. This study aimed to indicate the anatomical place with the most accurate results for . According to gastric mapping, this study will be able to evaluate the prevalence of based on the pathology of gastric mapping and the accuracy of the antral rapid urease test (RUT) based on endoscopic findings.
In this cross-sectional study, upper digestive endoscopy and gastric pathology were studied in 196 obese patients candidates for bariatric surgery. Statistical analyses were performed using a t-test and Chi-square/fisher's exact test to compare the groups. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) were used to compare RUT and pathological test of each of the six areas of the stomach. We set a positive test of the pathology of 6 regions of the stomach as our gold standard (in this study).
The most common area of the stomach for pathological findings of were incisura (116, 59.2%), greater curvature of the antrum (115, 58.3%), lesser curvature of the antrum (113, 57.7%), lesser curvature of the corpus (112, 57.1%), greater curvature of the corpus (111, 56.6%) and cardia (103, 52.6%). The prevalence of was 58.2% (114 cases) and 61.2% (120 cases) with RUT and gastric pathology, respectively. Mild, moderate, and severe infection of in cardia (58, 29.6%), greater and lesser curvature of the antrum (61, 31.1%), and greater curvature of the antrum (37, 18.9%) had the highest percentages of incidence comparing to other sites of the stomach, respectively. The most sensitive area for pathologic biopsy was incisura (96.6%, 95% confidence interval: 91.7, 98.7).
According to the highest sensitivity, PLR, NPV, and pathological findings of in accordance with the lowest NLR in the incisura compared with other parts of the stomach, it is highly recommended to take the biopsy from the incisura instead of other anatomical places of stomach for detecting specifically if our strategy is taking only one biopsy.
肥胖和（）感染是全球及伊朗面临的公共卫生问题。本研究旨在指出能得出最准确结果的解剖部位用于（）。根据胃黏膜地图绘制，本研究将能够基于胃黏膜地图病理学评估（）的患病率，并根据内镜检查结果评估胃窦快速尿素酶试验（RUT）的准确性。
在这项横断面研究中，对196名准备接受减重手术的肥胖患者进行了上消化道内镜检查和胃病理学研究。使用t检验和卡方检验/费舍尔精确检验进行统计分析以比较各组。敏感性、特异性、准确性、阳性预测值（PPV）、阴性预测值（NPV）、阳性似然比（PLR）、阴性似然比（NLR）和比值比（OR）用于比较胃的六个区域中每个区域的RUT和病理（）检测。我们将胃6个区域的病理检查阳性设定为我们的金标准（在本研究中）。
胃中（）病理结果最常见的区域是切迹（116例，59.2%）、胃窦大弯侧（115例，58.3%）、胃窦小弯侧（113例，57.7%）、胃体小弯侧（112例，57.1%）、胃体大弯侧（111例，56.6%）和贲门（103例，52.6%）。RUT和胃病理学检测中（）的患病率分别为58.2%（114例）和61.2%（120例）。与胃的其他部位相比，贲门（58例，29.6%）、胃窦大弯侧和小弯侧（61例，31.1%）以及胃窦大弯侧（37例，18.9%）的（）轻度、中度和重度感染发生率最高。病理活检最敏感的区域是切迹（96.6%，95%置信区间：91.7，98.7）。
与胃的其他部位相比，根据切迹处最高的敏感性、PLR、NPV以及（）的病理结果和最低的NLR，强烈建议在仅进行一次活检的策略下，从切迹而非胃的其他解剖部位进行活检以特异性检测（）。
