为伊朗病态肥胖患者选择最佳胃活检解剖位置以检测幽门螺杆菌

Q2 Medicine Medical Journal of the Islamic Republic of Iran Pub Date : 2024-02-07 eCollection Date: 2024-01-01 DOI:10.47176/mjiri.38.13
Ali Kabir, Shahrbanoo Abdolhosseini, Ali Zare-Mirzaei, Abdolreza Pazouki, Mohsen Masoodi, Shahram Agah, Amirhossein Faghihi Kashani
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引用次数: 0

摘要

背景:肥胖和幽门螺旋杆菌(H. pylori)感染是世界和伊朗的公共卫生问题。本研究旨在指出对幽门螺杆菌检测结果最准确的解剖部位。根据胃图,本研究将能根据胃图的病理变化评估幽门螺杆菌的感染率,并根据内窥镜检查结果评估前胃快速尿素酶试验(RUT)的准确性:在这项横断面研究中,对196名肥胖的减肥手术候选患者进行了上消化道内窥镜检查和胃病理学研究。采用 t 检验和 Chi-square/isher's 精确检验对各组进行统计分析比较。使用敏感性、特异性、准确性、阳性预测值(PPV)、阴性预测值(NPV)、阳性似然比(PLR)、阴性似然比(NLR)和几率比(OR)来比较胃部六个区域中每个区域的 RUT 和病理幽门螺杆菌检测。我们将胃部 6 个区域的病理检测呈阳性作为金标准(在本研究中):结果:幽门螺杆菌病理学检查最常见的胃部区域是切口(116,59.2%)、胃窦大弯(115,58.3%)、胃窦小弯(113,57.7%)、胃窦小弯(112,57.1%)、胃窦大弯(111,56.6%)和贲门(103,52.6%)。幽门螺杆菌感染率分别为 58.2%(114 例)和 61.2%(120 例)。与胃的其他部位相比,幽门螺杆菌在贲门(58 例,29.6%)、胃窦大弯和小弯(61 例,31.1%)以及胃窦大弯(37 例,18.9%)的轻度、中度和重度感染率分别最高。病理活检最敏感的部位是切口(96.6%,95% 置信区间:91.7, 98.7):根据切口与胃部其他部位相比最高的敏感性、PLR、NPV和幽门螺杆菌病理结果,以及最低的NLR,如果我们的策略是只做一次活检,那么强烈建议从切口而不是胃部其他解剖部位进行活检,以检测幽门螺杆菌。
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Selecting the Best Gastric Anatomical Place for Biopsy to Detect Helicobacter Pylori in Iranian Morbid Obese Patients.

Background: Obesity and Helicobacter pylori (H. pylori) infection are public health problems in the world and Iran. This study aimed to indicate the anatomical place with the most accurate results for H. pylori. According to gastric mapping, this study will be able to evaluate the prevalence of H. pylori based on the pathology of gastric mapping and the accuracy of the antral rapid urease test (RUT) based on endoscopic findings.

Methods: In this cross-sectional study, upper digestive endoscopy and gastric pathology were studied in 196 obese patients candidates for bariatric surgery. Statistical analyses were performed using a t-test and Chi-square/fisher's exact test to compare the groups. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and odds ratio (OR) were used to compare RUT and pathological H. pylori test of each of the six areas of the stomach. We set a positive test of the pathology of 6 regions of the stomach as our gold standard (in this study).

Results: The most common area of the stomach for pathological findings of H. pylori were incisura (116, 59.2%), greater curvature of the antrum (115, 58.3%), lesser curvature of the antrum (113, 57.7%), lesser curvature of the corpus (112, 57.1%), greater curvature of the corpus (111, 56.6%) and cardia (103, 52.6%). The prevalence of H. pylori was 58.2% (114 cases) and 61.2% (120 cases) with RUT and gastric pathology, respectively. Mild, moderate, and severe infection of H. pylori in cardia (58, 29.6%), greater and lesser curvature of the antrum (61, 31.1%), and greater curvature of the antrum (37, 18.9%) had the highest percentages of incidence comparing to other sites of the stomach, respectively. The most sensitive area for pathologic biopsy was incisura (96.6%, 95% confidence interval: 91.7, 98.7).

Conclusion: According to the highest sensitivity, PLR, NPV, and pathological findings of H. pylori in accordance with the lowest NLR in the incisura compared with other parts of the stomach, it is highly recommended to take the biopsy from the incisura instead of other anatomical places of stomach for detecting H. pylori specifically if our strategy is taking only one biopsy.

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CiteScore
2.40
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0.00%
发文量
90
审稿时长
8 weeks
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