Matsukura N, Onda M, Tokunaga A, Kato S, Yamashita K, Ohbayashi M
First Department of Surgery, Nippon Medical School, Tokyo, Japan.
J Gastroenterol. 1995 Dec;30(6):689-95. doi: 10.1007/BF02349633.
The detection of Helicobacter pylori in gastric juice by the polymerase chain reaction (PCR) was undertaken in 124 patients with peptic ulcer or chronic gastritis. PCR products were evaluated by agarose gel electrophoresis and Southern hybridization of H. pylori-specific DNA sequences. Positive and negative results of the PCR analysis in 72 examinations were compared with those from bacterial culture, and with the detection of tissue IgA antibody against H. pylori by enzyme-linked immunosorbent assay ELISA; Serion, Wuerzburg, Germany, and detection of serum IgG antibody against H. pylori by ELISA; Radim Pomezia, Italy. Thirty-four PCR-positive samples evaluated by electrophoresis and hybridization coincided with positive samples in 56% of bacterial cultures, 59% of tissue IgA antibody identifications, and 94% of serum IgG antibody evaluations; 26 PCR-negative samples coincided with negative samples in 96% of bacterial cultures, 81% of tissue IgA antibody evaluations, and 38% of serum IgG assessments. We compared the detection achieved with the H. pylori PCR assay in gastric juice with that in biopsies taken from the antrum and upper corpus in 90 examinations, and found them to be both positive in 34 (38%) and 36 (40%) of specimens, both negative in 37 (41%) and 30 (33%) specimens, gastric juice-positive but biopsy-negative in 10 (11%) and 12 (13%) specimens, and vice versa in 9 (10%) and 12 (13%) specimens, when detected by electrophoresis and hybridization, respectively, showing equivalent detection rates. In relation to the type of disease, the positive PCR assay results with gastric juice, evaluated by electrophoresis and hybridization, respectively, were: gastric ulcer 34/53 (64%) and 39/53 (74%), duodenal ulcer 23/38 (61%) and 25/38 (66%), and chronic gastritis 20/33 (61%) and 23/33 (70%), showing no significant difference in positive rates between peptic ulcer and chronic gastritis. Of the samples of 16 patients with H. pylori-positive gastric juice by the PCR assay, 7 were negative by PCR assay analyzed by electrophoresis and hybridization after the completion of treatment H. pylori. However, after treatment, 3 were negative on electrophoresis but still had positive results with hybridization, indicating that a minimal number of bacilli may have still remained. Detection of H. pylori in gastric juice has potential advantages for examining H. pylori infection in the entire stomach and for follow up after treatment for the eradication of H. pylori.
采用聚合酶链反应（PCR）对124例消化性溃疡或慢性胃炎患者的胃液进行幽门螺杆菌检测。通过琼脂糖凝胶电泳和幽门螺杆菌特异性DNA序列的Southern杂交对PCR产物进行评估。将72次检测中PCR分析的阳性和阴性结果与细菌培养结果以及通过酶联免疫吸附测定（ELISA）检测针对幽门螺杆菌的组织IgA抗体（德国维尔茨堡的赛里恩公司产品）、通过ELISA检测针对幽门螺杆菌的血清IgG抗体（意大利波梅齐亚的拉迪姆公司产品）的结果进行比较。通过电泳和杂交评估的34份PCR阳性样本与细菌培养阳性样本的符合率为56%，与组织IgA抗体检测阳性样本的符合率为59%，与血清IgG抗体检测阳性样本的符合率为94%；26份PCR阴性样本与细菌培养阴性样本的符合率为96%，与组织IgA抗体检测阴性样本的符合率为81%，与血清IgG抗体检测阴性样本的符合率为38%。我们在90次检测中比较了用幽门螺杆菌PCR检测法检测胃液与检测取自胃窦和胃体上部活检组织的结果，通过电泳和杂交检测发现，两者均为阳性的标本分别为34份（38%）和36份（40%），均为阴性的标本分别为37份（41%）和30份（33%），胃液阳性但活检组织阴性的标本分别为10份（11%）和12份（13%），反之亦然的标本分别为9份（10%）和12份（13%），显示检测率相当。就疾病类型而言，通过电泳和杂交分别评估的胃液PCR检测阳性结果为：胃溃疡34/53（64%）和39/53（74%），十二指肠溃疡23/38（61%）和25/38（66%），慢性胃炎20/33（61%）和23/33（70%），消化性溃疡和慢性胃炎的阳性率无显著差异。在16例PCR检测胃液幽门螺杆菌阳性的患者样本中，7例在幽门螺杆菌治疗结束后通过电泳和杂交分析的PCR检测为阴性。然而，治疗后，3例电泳结果为阴性但杂交结果仍为阳性，表明可能仍残留极少量杆菌。检测胃液中的幽门螺杆菌在检查全胃幽门螺杆菌感染以及幽门螺杆菌根除治疗后的随访方面具有潜在优势。
