The Korean Journal of Medicine

  • 제99권2호
  • /
  • Pages.104-110
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  • 2024
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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헬리코박터 파일로리 감염의 다양한 진단법

Various Diagnostic Methods for Helicobacter pylori Infection

  • 전한조 (고려대학교 의과대학 내과학교실 소화기내과) ;
  • 최혁순 (고려대학교 의과대학 내과학교실 소화기내과)
  • Han Jo Jeon (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Korea University College of Medicine) ;
  • Hyuk Soon Choi (Division of Gastroenterology & Hepatology, Department of Internal Medicine, Korea University College of Medicine)
  • 투고 : 2024.02.29
  • 심사 : 2024.04.01
  • 발행 : 2024.04.01
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초록

H. pylori는 위장 점막에 집락화하여 만성 위염, 장상피화생, 위궤양, 위암 등의 질환을 유발한다. H. pylori 감염의 진단은 위장 조직 여부에 따라 침습적 방법과 비침습적 방법으로 나뉜다. 비침습적 방법에는 요소호기 검사가 있으며 민감도, 특이도가 높지만 내성 균주를 알 수 없는 한계가 있다. 혈청 검사는 특이도가 높아 일차 검사로 적합하지만 민감도가 낮고 현성 감염을 구분하지 못해 해석에 주의가 필요하다. 소변 및 대변 검사는 가격이 저렴하고 단순하지만 민감도가 낮고 검사의 정확도가 검체 상태에 영향을 받는다. 조직 검사는 특이도가 높고, 항생제 내성에 관한 정보를 배양 및 분자 검사를 통해 얻을 수 있지만 침습적이며 조직 채취오류에 따른 위음성 가능성이 있다. 급속 요소분해효소 검사는 일차 검사로 적합하지만 검체 양과 기질에 따라 분석 시간 및 정확도가 달라질 수 있다. 배양 검사는 배양의 어려움 때문에 일차 검사로 적합하지 않다. PCR 검사는 H. pylori 내성 및 변이 유무를 확인하여 개인별 맞춤 치료를 가능하게 하지만 가격이 비싸고 고도의 전문성이 요구된다. 따라서 다양한 검사법을 잘 숙지하고 적용하는 것이 H. pylori 감염 진단과 치료에 가장 중요하다.

Helicobacter pylori (H. pylori) is a bacterium that colonizes the human stomach, leading to various gastrointestinal diseases including gastritis, peptic ulcers, and gastric cancer. There is no gold standard test that relies entirely on one method in H. pylori diagnosis. We must be aware of the pros and cons of various testing methods to perform an appropriate test according to the situation. Accurate diagnosis and eradication therapy are essential for disease management. Diagnostic methods include invasive techniques like tissue biopsy and rapid urease test, as well as non-invasive tests such as urea breath test, serology test, and stool antigen test. Each method has its advantages and limitations, requiring careful consideration in clinical practice. Understanding these diagnostic tools is crucial for effective H. pylori management and prevention of associated complications.

키워드

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