论文部分内容阅读
目的探讨唾液幽门螺杆菌(H.pylori)测试板(HPS)检测H.pylori感染的临床价值。方法对228例无明显消化道症状行胃镜检查的体检者进行HPS检测及快速尿素酶试验,175例同时行病理HE染色检测,146例同时行结肠镜检查,对结果进行分析。结果 1HPS与联合检测(RUT或病理HE染色)相比较,阳性检出率分别为47.8%、41.67%,阳性符合率(灵敏度)为84.2%,阴性符合率(特异度)为78.2%,准确率为75.4%,阳性预测值为73.4%,阴性预测值为87.4%;HPS与HE染色检测相比较,阳性检出率分别为47.8%、40%,灵敏度为85.7%,特异度为68.7%,准确率为75.4%,阳性预测值为64.5%,阴性预测值为87.8%;与RUT方法比较,灵敏度为88.7%,特异度为67.5%,准确率为73.2%,阳性预测值为50.5%,阴性预测值为94.1%。2行胃黏膜活检的175例中,病理分别诊断为萎缩、糜烂、胃息肉、肠上皮化生及不典型增生的病例,H.pylori感染均有着较高的检出率。对结果进行卡方检验,萎缩、肠上皮化生及不典型增生中,HPS与HE染色阳性检出率的差异有统计学意义。3146例同时接受了结肠镜检查,发现息肉的78例中,HPS、HE染色的阳性率分别为69.2%、45.4%,差异有统计学意义。息肉行内镜下切除后诊断为腺瘤性息肉的24例,对应HPS、HE染色的阳性率为66.7%、47.4%。结论 HPS具有操作简单、快速、无痛苦等优点。是临床筛查H.pylori感染的一种很有价值的非侵入性方法,值得临床进一步验证。同时,HPS对萎缩、腺瘤性息肉等癌前病变的筛查可能具有一定的价值。
Objective To investigate the clinical value of salivary H.pylori test plate (HPS) in detecting H.pylori infection. Methods HPS and rapid urease test were performed in 228 cases of gastroscopy without obvious gastrointestinal symptoms. 175 cases were examined by pathological HE staining at the same time, and 146 cases were examined by colonoscopy at the same time. The results were analyzed. Results The positive detection rate of 1HPS was 47.8% and 41.67% respectively compared with the combined detection (RUT or pathological HE staining), the positive coincidence rate (sensitivity) was 84.2% and the negative coincidence rate (specificity) was 78.2% Was 75.4%, the positive predictive value was 73.4% and the negative predictive value was 87.4%. The positive detection rates of HPS and HE staining were 47.8% and 40% respectively, with a sensitivity of 85.7% and a specificity of 68.7% The sensitivity was 88.7%, the specificity was 67.5%, the accuracy was 73.2%, the positive predictive value was 50.5%. The negative predictive value was 75.4%, the positive predictive value was 64.5% and the negative predictive value was 87.8% The value is 94.1%. 2 cases of gastric mucosal biopsy in 175 cases, the pathology were diagnosed as atrophy, erosion, gastric polyps, intestinal metaplasia and dysplasia cases, H.pylori infection has a higher detection rate. The results of chi-square test, atrophy, intestinal metaplasia and dysplasia, HPS and HE staining positive detection rate of the difference was statistically significant. Of the 3146 cases who underwent colonoscopy at the same time, the positive rates of HPS and HE staining were 69.2% and 45.4% respectively in 78 cases of polyps, the difference was statistically significant. Twenty-four cases diagnosed as adenomatous polyps after endoscopic resection of polyps were positive for HPS and HE with 66.7% and 47.4%, respectively. Conclusion HPS has the advantages of simple operation, fast, no pain and so on. It is a valuable noninvasive method for clinical screening of H.pylori infection and deserves further clinical validation. At the same time, HPS on atrophy, adenomatous polyps and other precancerous lesions screening may have some value.