Background/Aim: Several clinical conditions seriously hamper the diagnostic accuracy of the commonly used tests for Helicobacter pylori (Hp), 13 C-urea breath test (UBT) and stool antigen test (SAT). The present communication is a critical review of the potential limitations of UBT and SAT, and describes the approach on how these can be avoided. Drawbacks of the Hp tests: False-negative results are most often due to low bacterial load in the stomach due to: i) use of proton pump inhibitor medication; ii) use of antibiotics; iii) presence of atrophic gastritis and hypoacid stomach; iv); bleeding peptic ulcer; v) gastric cancer (GC) and vi) mucosal-associated lymphatic tissue lymphoma. The UBT also gives false-positive results when urease-producing bacterial species, other than Hp colonize an acid-free stomach. Importantly, neither UBT nor SAT are capable of 1091 This article is freely accessible online.

Background/Aim: The present study compared the accuracy of visually analyzed (VA) and automatically analyzed (AA) ColonView (CV) quick test; a new-generation immunochemical test (FIT) for Hb and Hb/Hp (Biohit Oyj, Helsinki, Finland) in subjects participating in colorectal cancer (CRC) detection in Brazil. A traditional gFOBT test (HemoccultSENSA) was used as a reference. Patients and Methods: A cohort of 368 colonoscopy-referral patients were asked to collect 3 consecutive fecal samples, to be analysed by both assays (CV, SENSA). Results: In receiver operating characteristic (ROC) analysis for the AA reading, the optimal cut-off value for CV Hb AA (test AA 3) was ≥117 and that for CV Hb/Hp AA (test AA 4) was ≥48. In the hierarchical summary receiver operating characteristic (HSROC) analysis for pooled accuracy of CV with AA and VA reading, the AUC values for i) VA and ii) AA were as follows: i) AUC=0.859 (95%CI=0.839-0.879), ii) AUC=0.931 (95%CI=0. 920-0.942) . The difference between these AUC values (Roccomp analysis) was statistically significant (p=0.0024). Conclusion: The present study confirms the previous studies on the applicability of the ColonView quick test (a new-generation FIT) in CRC screening.Previous randomized studies suggest that fecal occult blood test (FOBT) screening can reduce mortality from colorectal cancer (CRC) (1-5). Fecal occult blood (FOB) is measured using either the traditional guaiac-based tests or more recently introduced fecal immunochemical tests (FITs) (6-8). FITs have several advantages over guaiac-based FOBTs, including higher sensitivity and specificity, resulting in improved clinical performance and higher efficiency (6-8). According to European guidelines for quality assurance in CRC screening, another advantage in population screening is that FITs can be automated and user can adjust the cutoff at which a positive result is reported (9).Since the invention of the immunochemical test principle by Suovaniemi et al. (10) in the 1980's, an increasing number of FITs have been developed, particularly in Japan, the pioneering country of CRC screening, where different FITs have been the principal screening method since the early 1990's (8, 9). The FIT is based on the detection of the globin moiety of human hemoglobin or its degradation products. Although a plethora of FOBTs is available on the market, relatively few have been extensively tested for clinical sensitivity and specificity in CRC screening. Current data imply that new FITs have superior test characteristics as compared with guaiac-based FOBTs. As shown in our (8) recent meta-analysis, the ColonView quick test (CV; Biohit Oyj, Helsinki, Finland) is superior to the traditional guaiacbased FOB tests (gFOBT, HemoccultSENSA), making CV a perfect fecal immunochemical test (FIT) for organized CRC screening.

No abstract

Background/Aim: The GastroPanel ® test (Biohit Oyj) is interpreted by the GastroSoft ® application distinguishing eight biomarker profiles, of which five profiles have a morphological equivalent in the Updated Sydney System (USS) classification of gastritis, and 3 others specify functional disorders of the stomach: 1) high acid output, 2) low acid output, and 3) effects of proton pump inhibitor (PPI) medication. This study evaluated the prevalence of these biomarker profiles in dyspeptic patients. Patients and Methods: A cross-sectional study was designed to assess the point prevalence of these biomarker profiles in a random sample of 500 subjects derived from our archives of GastroPanel ® samples. Results: Reflux symptoms were reported by 35.2% and use of PPI medication by 36.8% of the study subjects. Biomarker profile 2 (high acid output) was the second most common GastroPanel ® profile in this cohort; 31.2%, second only (33.6%) to profile 1 (healthy stomach). Hp-infection was detected in 25.0% of the subjects. Profiles related to use of PPI (low acid output, PPI effect) were found in 7.4% of the cases. AG was uncommon, diagnosed in 14 patients only (2.8%). Conclusion: These data are derived from the population with the highest frequency of dyspepsia, and the results might have widespread implications in diagnostic and screening practices.

No abstract