Analysis of clinical diagnostic value of four detection methods in Helicobacter pylori infection

doi:10.19871/j.cnki.xfcrbzz.2023.05.009

Abstract

Abstract: Objective To evaluate the clinical performance and application values of common detection tools for Helicobacter pylori (H.pylori) infection, and provide guidance for the clinical diagnosis of H.pylori. Method From January 2020 to January 2022, a total of 276 patients who had upper gastrointestinal symptoms were selected to undertake the electronic gastroscopy and ¹³C-urea breath examination (¹³C-UBT) in the Gastroenterology Department of Shenzhen Dapeng New District Kuichong People's Hospital. Their gastric mucosa samples were collected for rapid urease test (RUT), bacterial culture and histopathological tests. In this study, the results of histopathological tests were taken as the "gold standard", other detection methods were compared and statistically analyzed. Result The positive rates of ¹³C-UBT, electronic gastroscopy, RUT, bacterial culture and histology were 91.30% (252/276), 65.58% (181/276), 79.71% (220/276), 73.19% (223/276) and 90.22% (249/276) respectively. The efficiency of various detection methods was ranked from high to low. Sensitivity：¹³C-UBT>RUT>bacterial culture >gastroscopy; Specificity：bacterial culture >¹³C-UBT> gastroscopy >RUT. The consistency test of ¹³C-UBT (Kappa=0.935) was the best. The Kappa value of bacterial culture and RUT were 0.624 and 0.431 respectively. But the Kappa value of (Kappa=0.246) gastroscopy was poor. ROC curve was used to compare and analyze the diagnostic effect of various detection methods: combination test (¹³C-UBT+ histology) >¹³C-UBT >bacterial culture >RUT >gastroscopy. Conclusion¹³C-UBT is the best non-invasive method to detect H.pylori infection. The sensitivity and accuracy of electronic gastroscopy of H.pylori infection diagnosis are poor. Although the specificity of bacterial culture is high, its sensitivity is relatively low. It costs long time and requires complex techniques. The performance of RUT is obviously inferior to that of histopathological examination. At present, gastroscopy plus histopathological examination has become a clinical routine. For patients requiring gastroscopy, ¹³C-UBT combined with histopathological examination is the optimal detection mode for the clinical diagnosis of H.pylori infection.

Key words: Helicobacter pylori, Detection method, Clinical diagnosis, Value analysis

CLC Number:

R372
R446

Chen Haiting, Zhang Shuzhen, Li Xuehong, Liu Aijun, Yang Weiqing. Analysis of clinical diagnostic value of four detection methods in Helicobacter pylori infection[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(5): 46-51.

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