Misawa K, Kumagai T, Shimizu T, Furihata K, Ota H, Akamatsu T, Katsuyama T
Department of Laboratory Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Eur J Clin Microbiol Infect Dis. 1998 Jan;17(1):14-9. doi: 10.1007/BF01584357.
To re-evaluate the accuracy of the serological test for Helicobacter pylori, fixation of biopsy specimens with Carnoy's solution (preserving the mucous layer in tissue preparations) followed by immunohistochemical staining (a new histological procedure) was used as the reference histological method instead of 10% formalin fixation followed by hematoxylin-eosin staining (the conventional histological procedure). Biopsy specimens (antrum and body) from 114 patients with gastritis (including non-ulcer dyspepsia) or gastric and/or duodenal ulcers were obtained by endoscopy and used for both bacteriological culture and histological examination. Serum samples were taken from all patients at the time of endoscopy. The serum levels of specific IgG and IgA antibodies for Helicobacter pylori were measured by commercial enzyme immunoassay kits. The reliability of the IgG and IgA measurements was evaluated by analyzing receiver operating characteristic curves obtained using the two histological procedures. With the conventional histological procedure as the reference, the sensitivity and specificity levels of the serological test were 87.2% and 82.1%, respectively. With the new histological procedure as reference, sensitivity and specificity were 94% and 96.7%, respectively. The insufficient accuracy reported for the serological test could be due to false-positive or false-negative results obtained when the conventional histological procedure is used as the reference. The new histological procedure used here revealed that the serological test for Helicobacter pylori is more reliable than previously thought.
为重新评估幽门螺杆菌血清学检测的准确性，采用卡诺氏液固定活检标本（保留组织切片中的黏液层），随后进行免疫组织化学染色（一种新的组织学方法）作为参考组织学方法，取代了10%福尔马林固定后苏木精-伊红染色（传统组织学方法）。通过内镜检查从114例胃炎（包括非溃疡性消化不良）或胃和/或十二指肠溃疡患者获取活检标本（胃窦和胃体），用于细菌培养和组织学检查。在进行内镜检查时采集所有患者的血清样本。使用商用酶免疫分析试剂盒测定幽门螺杆菌特异性IgG和IgA抗体的血清水平。通过分析使用两种组织学方法获得的受试者工作特征曲线来评估IgG和IgA测量的可靠性。以传统组织学方法作为参考，血清学检测的敏感性和特异性水平分别为87.2%和82.1%。以新的组织学方法作为参考，敏感性和特异性分别为94%和96.7%。血清学检测报告的准确性不足可能是由于以传统组织学方法作为参考时出现假阳性或假阴性结果。此处使用的新组织学方法表明，幽门螺杆菌血清学检测比之前认为的更可靠。
