Liên quan giữa nồng độ Pepsin trong nước bọt với kết quả nội soi và mô bệnh học ở bệnh nhân có triệu chứng trào ngược dạ dày thực quản
Nội dung chính của bài viết
Tóm tắt
Nghiên cứu mô tả trên 30 bệnh nhân có triệu chứng trào ngược dạ dày thực quản được thực hiện các kĩ thuật định tính và định lượng pepsin trong nước bọt (Peptest), nội soi đường tiêu hoá trên và sinh thiết niêm mạc thực quản trong quá trình nội soi. Tỉ lệ bệnh nhân có Peptest dương tính ở ít nhất một mẫu và dương tính ở cả hai mẫu nước bọt lần lượt là 100% và 83,3%. Tỉ lệ bệnh nhân có viêm niêm mạc thực quản trên nội soi và mô bệnh học lần lượt là 70% và 36,7%. Không có sự khác biệt về tỷ lệ Peptest dương tính giữa nhóm có và không có tổn thương viêm niêm mạc thực quản trên kết quả nội soi và mô bệnh học (p > 0,05). Nồng độ pepsin ở mẫu sau ăn tối và trước ăn sáng có trung vị lần lượt là 124,1 và 104,5 ng/ml và đều không có sự khác biệt có ý nghĩa thống kê giữa nhóm có và không có tổn thương viêm niêm mạc thực quản trên nội soi và mô bệnh học (p > 0,05).
Chi tiết bài viết
Từ khóa
Peptest, nội soi đường tiêu hóa trên, mô bệnh học, trào ngược dạ dày thực quản
Tài liệu tham khảo
1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. The American journal of gastroenterology. 2006;101(8):1900-1920; quiz 1943.
2. Min YW, Lim SW, Lee JH, et al. Prevalence of Extraesophageal Symptoms in Patients With Gastroesophageal Reflux Disease: A Multicenter Questionnaire-based Study in Korea. J Neurogastroenterol Motil. 2014;20(1):87-93.
3. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018;67(7):1351-1362.
4. N E Schindlbeck, A G Klauser, G Berghammer, W Londong, S A Muller-Lissner. Three year follow up of patients with gastrooesophageal reflux disease. Gut. 1992;33:1016-1019.
5. Dent J. Microscopic esophageal mucosal injury in nonerosive reflux disease. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2007;5(1):4-16.
6. Zentilin P, Savarino V, Mastracci L, et al. Reassessment of the diagnostic value of histology in patients with GERD, using multiple biopsy sites and an appropriate control group. The American journal of gastroenterology. 2005;100(10):2299-2306.
7. Race C, Chowdry J, Russell JM, Corfe BM, Riley SA. Studies of salivary pepsin in patients with gastro-oesophageal reflux disease. Alimentary pharmacology & therapeutics. 2019;49(9):1173-1180.
8. Wang YJ, Lang XQ, Wu D, et al. Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub-types of Gastroesophageal Reflux Disease and Gastroesophageal Reflux Disease-related Disorders. J Neurogastroenterol Motil. 2020;26(1):74-84.
9. Wang YF, Yang CQ, Chen YX, et al. Validation in China of a non-invasive salivary pepsin biomarker containing two unique human pepsin monoclonal antibodies to diagnose gastroesophageal reflux disease. Journal of digestive diseases. 2019;20(6):278-287.
10. Zhang M, Pandolfino JE, Zhou X, et al. Assessing different diagnostic tests for gastroesophageal reflux disease: a systematic review and network meta-analysis. Therapeutic advances in gastroenterology. 2019;12:1756284819890537.
11. Ocak E, Kubat G, Yorulmaz I. Immunoserologic pepsin detection in the saliva as a non-invasive rapid diagnostic test for laryngopharyngeal reflux. Balkan Med J. 2015;32(1):46-50.
12. Sami SS, Ragunath K. The Los Angeles Classification of Gastroesophageal Reflux Disease. Video Journal and Encyclopedia of GI Endoscopy. 2013;1(1):103-104.
13. Fiocca R, Mastracci L, Riddell R, et al. Development of consensus guidelines for the histologic recognition of microscopic esophagitis in patients with gastroesophageal reflux disease: the Esohisto project. Hum Pathol. 2010;41(2):223-231.
14. NICE. Peptest for diagnosing gastro-esophageal reflux. 2015.
15. Strachan T, Melter J, Barabasová A, et al. Pepsin in secretion from the upper respiratory tract as a marker of extraesophageal reflux in children. Cesko-Slovenska Pediatrie. 2017;72:176-181.
16. Du X, Wang F, Hu Z, et al. The diagnostic value of pepsin detection in saliva for gastro-esophageal reflux disease: a preliminary study from China. BMC gastroenterology. 2017;17(1):107.
17. Hayat JO, Gabieta-Somnez S, Yazaki E, et al. Pepsin in saliva for the diagnosis of gastro-oesophageal reflux disease. Gut. 2015;64(3):373-380.
18. Mohamed H, Khodeer S, Shaheen W. Study of pepsin level in saliva as a noninvasive marker for diagnosis of gastroesophageal reflux disease. 2020;33(1):94-100.
19. Iluyomade A, Olowoyeye A, Fadahunsi O, et al. Interference with daily activities and major adverse events during esophageal pH monitoring with bravo wireless capsule versus conventional intranasal catheter: a systematic review of randomized controlled trials. Dis Esophagus. 2017;30(3):1-9.
20. Rasijeff AMP, Jackson W, Burke JM, Dettmar P. PWE-172 Does salivary pepsin measurement change diagnostic outcome in patients investigated by 24h ph monitoring? Gut. 2015;64:A287.283-A288.
21. Li YW, Sifrim D, Xie C, Chen M, Xiao YL. Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2017;23(4):517-525.
22. Ismail-Beigi F, Horton PF, Pope CE, 2nd. Histological consequences of gastroesophageal reflux in man. Gastroenterology. 1970;58(2):163-174.
23. Zhou LY, Wang Y, Lu JJ, et al. Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology. Journal of digestive diseases. 2014;15(5):230-238.
24. Hershcovici T, Fass R. Nonerosive Reflux Disease (NERD) - An Update. J Neurogastroenterol Motil. 2010;16(1):8-21.
25. El-Serag HB. Epidemiology of non-erosive reflux disease. Digestion. 2008;78 Suppl 1:6-10.
2. Min YW, Lim SW, Lee JH, et al. Prevalence of Extraesophageal Symptoms in Patients With Gastroesophageal Reflux Disease: A Multicenter Questionnaire-based Study in Korea. J Neurogastroenterol Motil. 2014;20(1):87-93.
3. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018;67(7):1351-1362.
4. N E Schindlbeck, A G Klauser, G Berghammer, W Londong, S A Muller-Lissner. Three year follow up of patients with gastrooesophageal reflux disease. Gut. 1992;33:1016-1019.
5. Dent J. Microscopic esophageal mucosal injury in nonerosive reflux disease. Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association. 2007;5(1):4-16.
6. Zentilin P, Savarino V, Mastracci L, et al. Reassessment of the diagnostic value of histology in patients with GERD, using multiple biopsy sites and an appropriate control group. The American journal of gastroenterology. 2005;100(10):2299-2306.
7. Race C, Chowdry J, Russell JM, Corfe BM, Riley SA. Studies of salivary pepsin in patients with gastro-oesophageal reflux disease. Alimentary pharmacology & therapeutics. 2019;49(9):1173-1180.
8. Wang YJ, Lang XQ, Wu D, et al. Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub-types of Gastroesophageal Reflux Disease and Gastroesophageal Reflux Disease-related Disorders. J Neurogastroenterol Motil. 2020;26(1):74-84.
9. Wang YF, Yang CQ, Chen YX, et al. Validation in China of a non-invasive salivary pepsin biomarker containing two unique human pepsin monoclonal antibodies to diagnose gastroesophageal reflux disease. Journal of digestive diseases. 2019;20(6):278-287.
10. Zhang M, Pandolfino JE, Zhou X, et al. Assessing different diagnostic tests for gastroesophageal reflux disease: a systematic review and network meta-analysis. Therapeutic advances in gastroenterology. 2019;12:1756284819890537.
11. Ocak E, Kubat G, Yorulmaz I. Immunoserologic pepsin detection in the saliva as a non-invasive rapid diagnostic test for laryngopharyngeal reflux. Balkan Med J. 2015;32(1):46-50.
12. Sami SS, Ragunath K. The Los Angeles Classification of Gastroesophageal Reflux Disease. Video Journal and Encyclopedia of GI Endoscopy. 2013;1(1):103-104.
13. Fiocca R, Mastracci L, Riddell R, et al. Development of consensus guidelines for the histologic recognition of microscopic esophagitis in patients with gastroesophageal reflux disease: the Esohisto project. Hum Pathol. 2010;41(2):223-231.
14. NICE. Peptest for diagnosing gastro-esophageal reflux. 2015.
15. Strachan T, Melter J, Barabasová A, et al. Pepsin in secretion from the upper respiratory tract as a marker of extraesophageal reflux in children. Cesko-Slovenska Pediatrie. 2017;72:176-181.
16. Du X, Wang F, Hu Z, et al. The diagnostic value of pepsin detection in saliva for gastro-esophageal reflux disease: a preliminary study from China. BMC gastroenterology. 2017;17(1):107.
17. Hayat JO, Gabieta-Somnez S, Yazaki E, et al. Pepsin in saliva for the diagnosis of gastro-oesophageal reflux disease. Gut. 2015;64(3):373-380.
18. Mohamed H, Khodeer S, Shaheen W. Study of pepsin level in saliva as a noninvasive marker for diagnosis of gastroesophageal reflux disease. 2020;33(1):94-100.
19. Iluyomade A, Olowoyeye A, Fadahunsi O, et al. Interference with daily activities and major adverse events during esophageal pH monitoring with bravo wireless capsule versus conventional intranasal catheter: a systematic review of randomized controlled trials. Dis Esophagus. 2017;30(3):1-9.
20. Rasijeff AMP, Jackson W, Burke JM, Dettmar P. PWE-172 Does salivary pepsin measurement change diagnostic outcome in patients investigated by 24h ph monitoring? Gut. 2015;64:A287.283-A288.
21. Li YW, Sifrim D, Xie C, Chen M, Xiao YL. Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2017;23(4):517-525.
22. Ismail-Beigi F, Horton PF, Pope CE, 2nd. Histological consequences of gastroesophageal reflux in man. Gastroenterology. 1970;58(2):163-174.
23. Zhou LY, Wang Y, Lu JJ, et al. Accuracy of diagnosing gastroesophageal reflux disease by GerdQ, esophageal impedance monitoring and histology. Journal of digestive diseases. 2014;15(5):230-238.
24. Hershcovici T, Fass R. Nonerosive Reflux Disease (NERD) - An Update. J Neurogastroenterol Motil. 2010;16(1):8-21.
25. El-Serag HB. Epidemiology of non-erosive reflux disease. Digestion. 2008;78 Suppl 1:6-10.