Abstract
The purpose of the study was to identify and evaluate the practical value of the most common diagnostic methods for Helicobacter pylori infection in patients with chronic inflammation of the gastric mucosa.
 Materials and methods. The study involved 104 people. All the patients examined underwent esophagogastroduodenoscopy with a rapid urease histochemical test for Helicobacter pylori and a standard five-point biopsy of the gastric mucosa for morphological evaluation and bacterioscopy. If the result of the quick urease histochemical test coincided with the data of the biopsy study on Helicobacter pylori, no further examination was carried out. In case of discrepancy the patients additionally underwent the 13C-urease breath test.
 Results. It was found that the sensitivity of the rapid urease histochemical test in the area of the proposed model, according to our study, was 89.74% and the specificity was 46.15% when validating it using the additional methods. Similar calculations for the diagnostic method of staining by Giemsa showed sensitivity of 100% and specificity of 97.4%. The total number of the infected in the survey was 78 out of 104 people, which amounted to 75%.
 When analysing the severity of activity, inflammation and atrophic changes in the gastric mucosa, it was found that in the patients with two positive tests, the severity of the processes was significantly higher than in those with one positive test or all the tests were negative (p 0.05). When comparing the same processes in cases where only a quick urease histochemical test was positive and no signs of Helicobacteriosis were detected in any test, no significant differences were detected.
 Discussion. The rapid urease histochemical test showed good sensitivity of 89.74%, but unsatisfactory specificity of 46.15%, which severely limits its use. An unexpected result for this methodology was a large number of false positive tests, while the European recommendations indicate a more frequent occurrence of false negative results, which can be explained by differences in the production technology of the test systems. High sensitivity and specificity of the Helicobacter pylori test using Giemsa staining strongly depends on observing the methodology and experience of a specialist and cannot be recommended as a standard in the routine medical use.
 The study confirmed the recommendations for using at least two diagnostic tests to diagnose the infection, while the most common rapid urease histochemical test always needs confirmation. As a result of the analysis, it can be said that esophagastroduodenoscopy with a rapid urease histochemical test for Helicobacter pylori and standard diagnostic biopsy is the optimal method for diagnosing the pathology of the upper sections of the gastrointestinal tract. Moreover, 13C-UDT seems to be almost ideal as a screening technique and for evaluating treatment in cases where endoscopic monitoring is not necessary.
Highlights
Цель работы — изучить и оценить практическую ценность наиболее распространенных методов диагностики инфекции Helicobacter pylori у пациентов с хроническим воспалением слизистой оболочки желудка
If the result of the quick urease histochemical test coincided with the data of the biopsy study on Helicobacter pylori, no further examination was carried out
It was found that the sensitivity of the rapid urease histochemical test in the area of the proposed model, according to our study, was 89.74% and the specificity was 46.15% when validating it using the additional methods
Summary
Цель работы — изучить и оценить практическую ценность наиболее распространенных методов диагностики инфекции Helicobacter pylori у пациентов с хроническим воспалением слизистой оболочки желудка. Всем обследуемым выполняли эзофагогастродуоденоскопию с быстрым уреазным гистохимическим тестом на Helicobacter pylori и стандартной пятиточечной биопсией слизистой оболочки желудка для морфологической оценки и бактериоскопии. Быстрый уреазный гистохимический тест показал хорошую чувствительность (89,74 %), однако неудовлетворительную специфичность (46,15 %), что сильно ограничивает его использование. Высокая чувствительность и специфичность теста на Helicobacter pylori с использованием окраски по Гимзе зависит от соблюдения методики и опыта специалиста, поэтому этот тест не может быть рекомендован в качестве стандарта в рутинной практике. Исследование подтвердило, что для диагностики инфекции лучше выполнять не менее двух диагностических тестов, при этом наиболее распространенный быстрый уреазный гистохимический тест всегда следует подтверждать. При этом 13С-уреазный дыхательный тест практически идеально подходит в качестве скрининговой методики и для оценки лечения в тех случаях, когда в эндоскопическом контроле нет необходимости.
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