Feasibility of analysing [¹³C]urea breath tests for Helicobacter pylori by gas chromatography‐mass spectrometry in the selected ion monitoring mode

Abstract

The study demonstrates that a gas chromatograph-mass spectrometer can be used to analyse [13C]urea breath tests, thus potentially lowering the cost of the test and increasing the number of laboratories that can perform the test.

13C‐urea breath test without a test meal is highly accurate for the detection of Helicobacter pylori infection in Chinese

“…Using receiver operating characteristics (ROC) analysis, the optimal delta-value and optimal measurement interval for UBT were 5% and 30 min, respectively, both with or without a test meal. The sensitivity, speci®city, positive predictive value, negative predictive value and accuracy of 13 C-UBT with citric acid (96.5%, 97.7%, 98.2%, 95.6%, 97.0%) were similar to 13 samples every 10 min for 3 h. 5 Conventional 13 C-UBT uses a test meal to decrease gastric emptying and maximize the distribution of 13 C-urea within the stomach. It allows a better and longer contact time between the bacteria and the substrate, and may improve the diagnostic accuracy of 13 C-UBT by re¯ec-ting the urease activity of the whole stomach.…”

“…5 The amount of substrate used, type of test meal, number of samples and the sampling time were the key variables being investigated. The dose of 13 C-urea varies among different investigators, from 75 mg to 350 mg. A dose of 125 mg 13 C-urea was used in the validated US protocol 11 and 100 mg 13 C-urea was used in the standard European protocol. 2 However, the 75 mg low dose protocol has been shown to be equally reliable.…”

“…12 Although a lower cut-off value has been suggested by various studies, there is no universal agreement on the use of a lower cut-off value. 2,18 The commonly adopted sampling time is before and 30 min after the ingestion of 13 C-urea, although the initial description of the test took breath SUMMARY Background: Conventional 13 C-urea breath testing ( 13 C-UBT) includes a test meal to delay gastric emptying, which, theoretically, improves the accuracy of the test. Citric acid has been proposed as the best test meal.…”

“…Methods: Consecutive dyspeptic patients referred for upper endoscopy were recruited. 13 C-UBT was performed on two separate days with or without a test meal (2.4 Gm citric acid) and compared with the`gold standard' (CLO test and histology).…”

“…12,20,21 However, recent studies suggested that 13 C-UBT without a test meal may be equally reliable for the diagnosis of H. pylori infection. 22,23 Most of the published data about 13 C-UBT have come from the Western population. Relatively few reports has been published assessing the use of 13 C-UBT in a Chinese population.…”