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Comparaison entre cytologie, histologie et bactériologie de prélévements obtenus en cours d’endoscopie pour recherche du Campylobacter pylori (CP) dans deux situations cliniques : La dyspepsie non ulcéreuse et l’ulcère duodénal résistant

Camparison between cytological, histological and microbiological data obtained during endoscopic examination for Campylobacter pylori (CP) identification in two clinical ways: Non ulcerous dyspepsia and resistant peptic ulcer

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Acta Endoscopica

Résumé

La présence de Campylobacter pylori (CP) a été recherchée en comparant les techniques morphologiques (cytologie d’empreinte et histologie) et microbiologiques (test uréase) par rapport à la culture, prise comme référence, chez des patients référés pour examen endoscopique qui souffraient d’une maladie ulcéreuse duodénale résistante au traitement classique ou d’une dyspepsie non ulcéreuse.

Cent vingt sept patients sont étudiés. Six biopsies antrales sont systématiquement réalisées pour la culture, le test uréase (24h), l’histologie (coloration de Giemsa) et la cytologie d’empreinte. Un brossage de l’antre a été réalisé chez 41 patients.

Les vingt cinq patients ulcéreux duodénaux résistants montrent tous une gastrite antrale de type B. Le C. pylori est retrouvé à la culture chez 72 %, à l’histologie et à la cytologie chez 76 % et au test uréase chez 88 %.

Parmi les cent deux patients dyspeptiques non ulcéreux soixante douze ont une gastrite et trente en sont indemnes. Parmi ces derniers patients normaux, le C. pylori n’est jamais retrouvé ni à la culture, ni à la cytologie, ni à l’histologie. Cinq patients seulement ont un test uréase positif. Chez les 72 patients ayant une gastrite, 55 ont un test uréase positif, 54 une cytologie positive, 49 une histologie positive et 45 une culture positive pour le C. pylori.

La présence de C. pylori est significativement plus importante chez les patients ulcéreux duodénaux résistants et les dyspeptiques non ulcéreux. L’utilisation combinée des méthodes morphologiques et microbiologiques décrites sont utiles pour le détecter.

Summary

Patients with resistant duodenal peptic ulcer (RDU) and non ulcerous dyspepsia (NUD) referred for upper GI endoscopy were evaluated for the presence of Campylobacter pylori (CP) to determine the value of morphological tests (touch biopsy cytology and histology) and bacteriological tests (urease test) in comparison with culture of C. pylori as reference test.

One hundred twenty seven patients were studied. Six antral biopsy specimens were taken for culture, urease test (24h), histology (morphology and Giemsa staining), cytology (touch biopsy). All patients (25) with RDU have a type B gastritis. C. pylori was found by culture in 72 %, histology and cytology in 76 %, urease test in 88 %.

Among one hundred two patients with NUD, seventy two had a type B gastritis and thirty were normal. Among these last normals no C. pylori was found by cytology, histology nor culture, urease test was positive in five.

In NUD patients with gastritis the results were: 55 urease test +, 54 cytology CP +, 49 histology CP +, and 45 culture CP +.

The presence of C. pylori is significant in patients with RDU and NUD. Combined utilisation of morphological and bacteriological test is useful to detect the presence of C. pylori.

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Authors and Affiliations

  1. Service d’Hépato-Gastroentérologie, Hôpital Civil de Jumet, Rue de Gosselies 73, B-6040 Jumet, Charleroi, Belgique

    V. Lamy, D. Fameree, J. Cappelli & R. Moisse

  2. Institut de Morphologie Pathologique de Loverval, Belgique

    D. Faverly & M. Fievez

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  1. V. Lamy
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  2. D. Fameree
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  3. D. Faverly
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Lamy, V., Fameree, D., Faverly, D. et al. Comparaison entre cytologie, histologie et bactériologie de prélévements obtenus en cours d’endoscopie pour recherche du Campylobacter pylori (CP) dans deux situations cliniques : La dyspepsie non ulcéreuse et l’ulcère duodénal résistant. Acta Endosc 17, 271–281 (1987). https://doi.org/10.1007/BF02968453

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