Diagnostic value of porphobilin staining of gastric mucus for primary pathological duodenogastric reflux / 中华消化内镜杂志

ABSTRACT

Objective To study the diagnostic value of porphobilin staining of gastric mucus for primary pathologic duodenogastric reflux (DGR). Methods A total of 58 DGR patients diagnosed from January, 2007 to April, 2008 were recruited to the study as DGR group, and 21 healthy volunteers as control.All subjects underwent 24-hour intragastric bilirubin monitor and gastroscopy. Bilirubin absorption value of 0. 25 and median reflux time of 23.60% were taken as thresholds to differentiate low reflux group ( reflux time ＜ 23.60% ) and high reflux group (reflux time ≥23.60% ). Porphobilin staining of gastric mucosa was quantitatively analyzed. Results Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in primary pathologi DGR group was significantly higher than those in healthy group (P ＜0. 05 ). The occurrence of atrophic and intestinal metaplasia of gastric antrum in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05). Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05 ). The New Sydney system pathological scores of gastric antrum and angle of high reflux group was higher than that of low reflux group ( P ＜ 0. 05 ). The deposition of porphobilin in mucosa of gastric antrum and gastric angle was positively correlated with New Sydney system pathological scores in primary pathological DGR group (r=0.59, P=0.041 andr=0.73, P=0.038). Conclusion Porphobilin staining of mucosa in gastric antrum can reflect the severity of bile reflux, and is positively correlated with the extent of gastric mucosal lesion, which may be helpful in diagnosis of primary pathological DGR.