CAJ | 학술논문

目的：评估一种全新的幽门螺杆菌（HP）检测方法，即利用多重基因分析系统（GeXP系统）检测HP感染。方法分别用培养法、快速尿素酶法、普通聚合酶链反应（PCR）和多重基因检测法检测胃活检组织标本中的HP，用Stata 12．0统计软件评估各种方法的敏感性、特异性、阳性预测值、阴性预测值，从检测方法角度横向评估多重基因法检测HP的有效性；选取16S rRNA、ureA、ureC、26KDa、cagA基因作为HP的诊断基因并做多重基因检测，从多重基因检测角度纵向评估GeXP系统检测HP感染的有效性。结果培养法的敏感性为76．8％，特异性为100．0％，阳性预测值为100．0％，阴性预测值为57．7％；快速尿素酶法的敏感性为87．8％，特异性为80．8％，阳性预测值为93．5％，阴性预测值为67．7％；普通PCR的敏感性和特异性最高，均为100．0％。GeXP系统敏感性和特异性分别为100．0％和71．3％，阳性预测值为90．9％，阴性预测值为100．0％。结论初步建立的诊断HP感染的多重基因检测法（GeXP系统）具有高敏感性、高特异性以及高通量的特点，不仅可以满足临床标本检测的需求，还可以进行根除治疗后的预后监测，具有很高的临床应用价值。
목적：평고일충전신적유문라간균（HP）검측방법，즉이용다중기인분석계통（GeXP계통）검측HP감염。방법분별용배양법、쾌속뇨소매법、보통취합매련반응（PCR）화다중기인검측법검측위활검조직표본중적HP，용Stata 12．0통계연건평고각충방법적민감성、특이성、양성예측치、음성예측치，종검측방법각도횡향평고다중기인법검측HP적유효성；선취16S rRNA、ureA、ureC、26KDa、cagA기인작위HP적진단기인병주다중기인검측，종다중기인검측각도종향평고GeXP계통검측HP감염적유효성。결과배양법적민감성위76．8％，특이성위100．0％，양성예측치위100．0％，음성예측치위57．7％；쾌속뇨소매법적민감성위87．8％，특이성위80．8％，양성예측치위93．5％，음성예측치위67．7％；보통PCR적민감성화특이성최고，균위100．0％。GeXP계통민감성화특이성분별위100．0％화71．3％，양성예측치위90．9％，음성예측치위100．0％。결론초보건립적진단HP감염적다중기인검측법（GeXP계통）구유고민감성、고특이성이급고통량적특점，불부가이만족림상표본검측적수구，환가이진행근제치료후적예후감측，구유흔고적림상응용개치。
Objective To evaluate a new kind of Helicobacter pylori (HP)detection method,using the multiple genetic analysis system (GeXP system)to detect HP infection.Methods Use culture method,rapid urease test, ordinary polymerase chain reaction (PCR)and multiple genetic testing to determine whether gastric biopsies exist HP. The sensitivity,specificity,positive predictive value and negative predictive value were evaluated by Stata 1 2.0 statistical software,in order to evaluate the testing performance of GeXP system from horizontal degree.Furthermore, multiple genetic testing was performed by selecting 5 specific genes(1 6S rRNA,ureA,ureC,26KDa and cagA genes)as HP diagnosis infection,and multiple genetic testing was evaluated from longitudinal degree.Results The sensitivity of culture method was 76.8%,the specificity was 1 00.0%,the positive predictive value was 1 00.0%,and the negative predictive value was 57.7%.For rapid urease test,by contrast,its sensitivity was 87.8%,the specificity was 80.8%, the positive predictive value was 93.5%,and the negative predictive value was 67.7%.Ordinary PCR had the highest sensitivity and specificity (1 00.0%).For GeXP system,the sensitivity was 1 00.0%,the specificity was 71 .3%without false negative case,the positive predictive value was 90.9%,and the negative predictive value was 1 00.0%. Conclusions The new preliminary multiple genetic testing,GeXP system,has high sensitivity and specificity and high flux characteristics,which would not only meet the needs of clinical sample determination,but also could monitor prognosis after receiving eradication therapy.The GeXP system has a promising application significance.