Role of rapid urease test and histopathology in the diagnosis of Helicobacter pylori infection in a developing country
Role of rapid urease test and histopathology in the diagnosis of Helicobacter pylori infection in a developing country
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DOI：
10.1186/1471-230x-5-38
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发表时间：
2005-11-25
影响因子：
2.4
通讯作者：
Shaikh, H
中科院分区：
文献类型：
--
作者：
Yakoob, J;Jafri, W;Shaikh, H
背景：本研究的目的是确定常用的自行处方质子泵抑制剂 (PPI) 对诊断幽门螺杆菌感染的快速尿素酶试验和组织学结果的影响。方法：连续 190 例参加内镜检查的有消化不良症状的患者纳入本研究。在内窥镜检查中收集胃窦活检标本，用于快速尿素酶测试（Pronto Dry，法国医疗器械公司）和组织病理学。将 Pronto Dry 测试的敏感性、特异性、阳性预测值 (PPV)、阴性预测值 (NPV) 以及阳性和阴性的似然比与组织学进行比较。诊断幽门螺杆菌感染的金标准测试是组织病理学。结果：61% (66/109) 患者为男性，平均年龄为 43 +/- 14.1 岁，年龄范围为 17-80 岁。 52% (57/109) 的患者在就诊之前未服用任何药物，而 48% (52/109) 的患者在就诊之前使用过 PPI。 Pronto Dry 的阳性率为 40% (44/109)，阴性率为 60% (65/109)。 57% (62/109) 的组织病理学幽门螺杆菌呈阳性，43% (47/109) 呈阴性。使用和不使用 PPI 的阳性和阴性 Pronto Dry 测试的敏感性、特异性、PPV、NPV 和似然比分别为 43.3%、86.4%、81.3%、3.18、0.656 和 52.8% vs 71.9%、80%、82.1%、69%、3.59 和 0.35。 结论：本研究表明，使用 PPI 的患者，快速尿素酶试验的敏感性、特异性、NPV 和 PPV 降低。对于既往使用过 PPI 的患者，不建议仅使用快速尿素酶检测来诊断幽门螺杆菌。
Background: The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection.Methods: One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard test for the diagnosis of H. pylori infection was histopathology.Results: Sixty-one percent (66/109) patients were males with mean age of 43 +/- 14.1 years and age range 17-80 years. Fifty-two percent (57/109) were not on any medications while 48% (52/109) used PPI before presentation to the outpatients. Pronto Dry was positive in 40% (44/109) and negative in 60% (65/109). Histopathology was positive for H. pylori in 57% (62/109) and negative in 43% (47/109). The sensitivity, specificity, PPV, NPV and like-hood ratio of a positive and negative Pronto Dry test with and without PPI were 43.3%, 86.4%, 81.3%, 3.18, 0.656 and 52.8% vs 71.9%, 80%, 82.1%, 69%, 3.59 and 0.35.Conclusion: This study shows that the sensitivity, specificity, NPV and PPV of rapid urease test was reduced in patients who are on PPI. The exclusive use of the rapid urease test for the diagnosis of Helicobacter pylori cannot be recommended in patients with prior PPI use.