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首页> 外文期刊>World Journal of Gastroenterology >Clinical role and importance of fluorescence in situ hybridization method in diagnosis of H pylori infection and determination of clarithromycin resistance in H pylori eradication therapy
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Clinical role and importance of fluorescence in situ hybridization method in diagnosis of H pylori infection and determination of clarithromycin resistance in H pylori eradication therapy

机译：荧光原位杂交方法在幽门螺杆菌感染诊断及根除幽门螺杆菌中克拉霉素耐药性测定中的临床作用和重要性

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摘要

H pylori is etiologically associated with gastritis, gastric and duodenal ulcers, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. Eradicating H pylori may convert rapidly the outcome of related diseases with the use of more accurate diagnostic molecular tests. Indeed some of the tests cannot give the evidence of current infection; H pylori can be detected by noninvasive and invasive methods, the latter requiring an endoscopy. Eradication failure is a big problem in H pylori infection. Recently, clarithromycin resistance in H pylori strains is increasing and eradication therapy of this bacterium is becoming more difficult. Molecular methods have frequently been applied besides phenotypic methods for susceptibility testing to detect clarithromycin resistance due to mutations in the 2143 and 2144 positions of 23S rRNA gene. Fluorescence in situ hybridization (FISH) method on paraffin embedded tissue is a rapid, accurate and cost-effective method for the detection of H pylori infection and to determine clarithromycin resistance within three hours according to the gold standards as a non-culture method. This method can also be applied to fresh biopsy samples and the isolated colonies from a culture of H pylori, detecting both the culturable bacillary forms and the coccoid forms of H pylori, besides the paraffin embedded tissue sections. This technique is helpful for determining the bacterial density and the results of treatment where clarithromycin has been widely used in populations to increase the efficacy of the treatment and to clarify the treatment failure in vitro.
机译：幽门螺杆菌在病因上与胃炎，胃和十二指肠溃疡，胃腺癌和与黏膜相关的淋巴样组织（MALT）淋巴瘤有关。根除幽门螺杆菌可以通过使用更准确的诊断性分子检测来快速转换相关疾病的结果。实际上，某些测试无法提供当前感染的证据。幽门螺杆菌可以通过非侵入性和侵入性方法进行检测，后者需要进行内窥镜检查。根除失败是幽门螺杆菌感染中的一个大问题。近来，幽门螺杆菌菌株中的克拉霉素抗性正在增加，并且根除该细菌变得越来越困难。除表型方法外，还经常使用分子方法进行药敏试验，以检测由于23S rRNA基因2143和2144位突变引起的克拉霉素抗性。石蜡包埋组织的荧光原位杂交（FISH）方法是一种快速，准确且经济高效的方法，用于检测幽门螺杆菌感染，并根据金标准在三小时内确定对克拉霉素的抗性，作为一种非培养方法。该方法还可应用于新鲜的活检样品和幽门螺杆菌培养物中的分离菌落，除石蜡包埋的组织切片外，还可检测幽门螺杆菌的可培养细菌形式和球状形式。该技术有助于确定细菌密度和治疗效果，其中克拉霉素已在人群中广泛使用，以提高治疗效果并阐明体外治疗失败。

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