An evaluation of invasive and non‐invasive tests for the diagnosis of Helicobacter pylori infection in Chinese

Abstract

Background: Different tests are available for diagnosing Helicobacter pylori infection. Aim: To compare the most commonly used tests either alone or in combination in Chinese patients with respect to routine clinical use or research purpose. Methods: A total of 294 consecutive dyspeptic patients without previous H. pylori treatment were recruited. During upper endoscopy, biopsies were taken from the antrum and corpus, for a commercially available CLO‐test, an in‐house rapid urease test, culture, polymerase chain reaction and histological examination. Patients then received a 13C‐urea breath test. The H. pylori status of each patient was determined by a concordance of test results. Results: For routine clinical use, histology (antral plus corpus biopsies) had an accuracy of 100%, whilst the rapid urease test had an accuracy of 99.7%. The 13C‐urea breath test was equally reliable, with an accuracy of 94.5%. Combinations of two tests did not confer additional advantage over the most accurate single test. For research purposes, the accuracy of using the criteria of two positives out of three diagnostic tests was 100% and equivocal results were not found. Conclusion: Histology with or without a rapid urease test was highly accurate for routine clinical use. Alternatively, the 13C‐urea breath test was an equally reliable non‐invasive test. The two positives out of three tests approach was highly reliable in predicting H. pylori status of untreated Chinese patients in a research setting.

Twenty‐minute 50 mg 13C‐urea breath test without test meal for the diagnosis of Helicobacter pylori infection in Chinese

“…The accuracy of the 13 C-UBT in diagnosing H. pylori infection is high, with a sensitivity of 90±98% and a speci®city of 92±100%. 1±5 The sensitivity and speci®city of posttreatment 13 C-UBT are as high as pre-treatment 13 C-UBT making it a reliable test for the determination of post-treatment H. pylori status. 6 Since it was ®rst described by Graham et al the test has been modi®ed extensively, including variations in the dose of 13 C-urea, sampling time, test meal and the cut-off values.…”

“…1±5 The sensitivity and speci®city of posttreatment 13 C-UBT are as high as pre-treatment 13 C-UBT making it a reliable test for the determination of post-treatment H. pylori status. 6 Since it was ®rst described by Graham et al the test has been modi®ed extensively, including variations in the dose of 13 C-urea, sampling time, test meal and the cut-off values. 7 The test meal in the 13 C-UBT was used to increase the residence time of 13 C-urea in the stomach and improve the contact between urease produced by H. pylori and 13 C-urea.…”

“…6 Since it was ®rst described by Graham et al the test has been modi®ed extensively, including variations in the dose of 13 C-urea, sampling time, test meal and the cut-off values. 7 The test meal in the 13 C-UBT was used to increase the residence time of 13 C-urea in the stomach and improve the contact between urease produced by H. pylori and 13 C-urea. Recently, citric acid has been proposed as the best liquid test meal.…”

“…The 13 C-urea breath test ( 13 C-UBT) is a technically simple and non-invasive test for the diagnosis of Helicobacter pylori (H. pylori) infection. The accuracy of the 13 C-UBT in diagnosing H. pylori infection is high, with a sensitivity of 90±98% and a speci®city of 92±100%.…”

Effect of treatment of Helicobacter pylori on the prevention of gastroduodenal ulcers in patients receiving long‐term NSAIDs: a double‐blind, placebo‐controlled trial

“…In the intention-to-treat analysis, five patients (7.1%; 95% CI, 2-16) in the treatment group developed peptic ulcers (all gastric ulcers) at the end of 12 weeks, compared with six patients (8.6%; 95% CI, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] in the placebo group (four gastric ulcers and two duodenal ulcers) (P ¼ 1.00). The ulcer size ranged from 5 to 12 mm.…”