Comparison of Four Diagnostic Methods for Helicobacter pylori

四種診斷幽門曲狀桿菌方法的比較研究

曾志恩(Jeh-En Tzeng) ； 林英龍(Ying-Lung Lin) ； 張淑美(Sue-Mei Chung) ； 邱怡翠(Yi-Tsui Chu)

《慈濟醫學雜誌》 17卷5期 (2005/10) Pp. 339-343

https://doi.org/10.6440/TZUCMJ.200510.0339

並列摘要

Objective: To compare the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of four different H. pylori diagnostic methods, and to correlate the histological analysis of the gastric mucosa with H. pylori infection. Materials and Methods: One hundred and eleven antral biopsies were collected and four different H. pylori diagnostic procedures were performed, namely H&E stain, Giemsa stain, rapid urease test, and imprint cytology. The histology of the gastric mucosa was also interpreted. Results: Forty five of the 48 patients (93.8%) who showed chronic active gastritis demonstrated H. pylori infection, but only eight of the 47 patients (17.0%) who showed chronic gastritis presented with H. pylori infection. Sixty of 111 patients (54.1%) tested positive for H. pylori infection by all four diagnostic methods, and 43 patients (38.7%) were negative infection by all four diagnostic methods. Four patients showed positive infection by three diagnostic methods, two were positive by two methods, and the last two tested were positive for H. pylori infection by only one method. There was no difference in the sensitivity, specificity, and PPV for the four diagnostic methods (p＞0.05). Finally, the NPV of the imprint cytology showed a significant difference from H&E and Giemsa stains (p＜0.05), but no difference from the rapid urease test. Conclusions: Histologically, H. pylori infection was associated with chronic active gastritis more often than with chronic gastritis. The four different diagnostic methods performed equally well in terms of sensitivity, specificity, PPV and NPV, except for the NPV of imprint cytology. In cases where the level of H. pylori infection is low, it is recommended that more than one diagnostic method should be utilized to decrease the false-negative rate.

並列關鍵字

Helicobacter pylori ； Giemsa stain ； rapid urease test ； imprint cytology