Clinical value of Breath-Card Method ~(14)C-Urea Breath Test in diagnosis of Helicobacter pylori infection
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Objective To explore the clinic value of breath-card method[KG-1mm] ~(14)C-urea breath test in diagnosis of Helicobacter pylori infection. Methods The samples were taken from subjects with empty stomach or 3 hours after eating,gargling and taking a[KG-1mm] ~(14)C-Urea capsule orally,waiting for 15 min and then breathing the breath-card for a duration of 2 to 5 min till the screen changed from blue to white.Totally 520 out of the 1507 patients were examined by gastroscope. Results The total positive rate was 42.66%,re-examination positive rate was 17.95%.The positive rates of peptic ulcer,gastritis and gastric carcinoma in the 520 patients examined by gastroscope were 91.91%,76.42% and 62.07% respectively. Conclusion The breath-card method ~(14)C-Urea breath test is a useful method for diagnosis of Helicobacter pylori infection.Keywords:
Urea breath test
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The 13C-urea breath test is now a practical and readily available alternative to endoscopy- and serology-based methods for the detection of H. pylori infection. It can detect very low levels of H. pylori colonization within the stomach by assessing the entire mucosa, and avoids the risks of sampling error. We performed the 13C-urea breath test in asymptomatic volunteers and patients with gastric and duodenal ulcers in order to compare the sensitivity and specificity by measurement of H. pylori antibody by ELISA. The positive rates of H. pylori in the 13C-urea breath test was correspondent with the results from the H. pylori antibody test, although no correlation in the antibody titers and urease activities was observed between the two methods. The 13C-urea breath test was the most useful method in evaluation of eradication of H. pylori after administration of antibiotics, compared to serological and pathological methods. These results suggest that the 13C-urea breath test is highly useful for the diagnosis of H. pylori infection of the gastric mucosa.
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Among 92 patients with chronic gastritis we conducted a synchronous diagnosis of the Helicobacter pylori (H. pylori) infection using a culture and a serological test (IFP), in conjunction with breath and urine tests involving (14)C-urea (BTU-C14 and UTU-C14). The infection was confirmed by isolation in 71 persons (77.2%), the presence of specific IgG in the blood serum was found in 75 (81.5%). In comparison, the BTU-C14 indicated a group of 77 people (83.7%) as infected, and the UTU-C14 a group of 76 (82.6%). In order to determine the diagnostic value (sensitivity, specificity and efficiency) of the latter tests, the results were compared with those of the culture and of the serological tests. It was found that the BTU-C14 test used showed a 100% sensitivity, a 89.5% specificity and a 97.9% efficiency. The UTU-C14 test showed a 100.0% sensitivity, a 94.4% specificity and a 98.9% efficiency in the detection of the H. pylori infection.
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Objective : To evaluate the diagnostic efficacy of ~(13)C-urea breath test(~(13)CUBT) for Helicobactor pylori(HP) in patients with chronic gastritis.Method: 40 patients presenting gastric symptoms underwent gastric mucosa biopsy while doing gastroscopy.All samples were analyzed by Wartin-Stany dying(WS), rapid urase test(RUT),and ~(13)C-urea breath test respectively as well as by histological examination.The patients with the same results by WS and RUT were regarded as chronic gastritis.In this patient,we analyzed the specificity,sensitivity and accuracy of ~(13)CUBT.Result: The specificity,sensitivity and accuracy of ~(13)CUBT for the chronic gastritis were 82%,91%,and 87% respectively.Conclusion: ~(13)CUBT is a sensitive,specific,safe and reliable invasive method for HP.
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Helicobacter
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In order to evaluate the value of serology and 14C-urea breath test in monitoring the effect of anti-Helicobacter pylori chemotherapy, at the first stage of this study, endoscopy, 14C-urea breath test and serology (H. pylori IgG antibody measured by ELISA) were performed in 42 of patients before the onset of anti-H pylori chemotherapy and at 1, 3, 6 and 12 months after termination of the treatment. On analyzing the change of the results of breath test and serology during the one year follow-up period in these patients, "above the cutoff value" in breath test and "reduction of A value less than 15% when comparing with pretreatment" in serology were made as the H. pylori positive criteria for monitoring therapeutic effectiveness on H. pylori. At the second stage of this study, total of another 63 of patients were studied to test the accuracy of the monitoring criteria. The results showed that the sensitivity of breath test was all 100.0% and specificity 95.5% and 100.0% respectively at 6 and 12 month after termination of treatment, the sensitivity of serology was all 100.0% and specificity was 50.0% and 83.3% respectively. A scheme for monitoring the effect of anti-H. pylori chemotherapy by combination of 14C-urea breath test and serology is proposed based on this study.
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Urea breath test
Spirillaceae
Organic disease
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Objective:To study the value of 14 C-urea breath test for the diagnosis of helicobacter pylori(HP)infection.Methods: 14 C-urea breath test and blood anti_HP antibody detection at the same time were examined in80patients with HP positiveness documented by gastric biopsy.Results:The positive rate of 14 C-urea breath test in80patients with HP positiveness documented by gastric biopsy was92.5%,and the positive rate of blood anti-HP antibody was60%.There was a significant difference between 14 C-urea breath test and blood anti-HP antibody detection(P0.05).Conclusion: 14 C-urea breath test is a good non-invasive method for the diagnosis of HP.
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ABSTRACT Twenty‐five Helicobacter pylori positive and 25 H. pylori negative subjects as defined by culture and phase contrast microscopy of antral biopsy specimens obtained from routine upper endoscopy were studied. Antral biopsies were examined by rapid urease test, phase contrast microscopy, culture and histology. Venous blood was tested for H. pylori specific IgG antibodies by an ELISA technique. Within 7 days of endoscopy the patients also had a [ 14 C]‐urea breath test. The sensitivity and specificity of the rapid urease test was 92%, the breath test 96% and 100%, histopathology 96% and 91% and serology 96% and 88%, respectively. The [ 14 C]‐urea breath test performed over 1 h with sampling of subjects at 0, 0.5 and 1 h was an accurate and reliable method. Results expressed as counts per minute of the expired 14 CO 2 proved to be a simple method of assessing H. pylori status. A significant correlation between severity of histological antral gastritis and the amount of 14 CO 2 expired was observed. This study has shown that the non‐invasive 14 C‐urea breath test and serology are highly sensitive and specific for the diagnosis of H. pylori infection.
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Histopathology
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In adults, the 13C-urea breath test (UBT) has been widely used as a noninvasive test of Helicobacter pylori infection because of its high sensitivity and specificity. However, this test is less well established in pediatric practice. The optimum cutoff value and test protocol of the 13C-UBT remains to be established in the pediatric population. The primary purpose of this study was to evaluate diagnostic accuracy of the 13C-UBT for children and to determine its optimum cutoff value.A total of 220 Japanese children aged 2-16 yr (mean = 11.9) who underwent upper GI endoscopy and gastric biopsies were finally studied. Endoscopic diagnoses included gastritis (n = 131), gastric ulcer (n = 15), duodenal ulcer (n = 72), and combined ulcer (n = 2). H. pylori infection status was confirmed by biopsy tests including histology, urease test, and culture. With the 13C-UBT, breath samples were obtained at baseline and at 20 min after ingestion of 13C-urea without a test meal and were analyzed by isotope ratio mass spectrometry. Based on biopsy tests, a cutoff value was determined using a receiver operating characteristic curve. In 26 children (seven children infected and 19 noninfected), paired breath samples were also measured by nondispersive infrared spectometry (NDIRS).Biopsy tests demonstrated that 89 children (40%) were infected with H. pylori and 131 children were not infected. There were no statistical differences in mean delta 13C values at 20 min between male and female H. pylori-infected and noninfected patients. A receiver operating characteristic analysis defined the best cutoff value as 3.5 per thousand. The overall sensitivity and specificity at a cutoff value of 3.5 per thousand were 97.8% (95% CI = 92.1-99.7%) and 98.5% (95% CI = 96.4-100%), respectively: high sensitivity and specificity were demonstrated in all three age groups (< or =5, 6-10, and > or = 11 yr). There was a close correlation between the values with isotope ratio mass spectrometry and NDIRS methods (r = 0.998, p < 0.001).The 13C-UBT with a cutoff value of 3.5 per thousand is an accurate diagnostic method for active H. pylori infection. The test with the NDIRS method is inexpensive and might be widely applied in clinical practice.
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The urea breath test (UBT) has been proposed as the most accurate test for diagnosing Helicobacter pylori infection. The aim of this work was to evaluate the accuracy of the UBT and to compare the results with histologic and endoscopic findings in H. pylori infected patients.One-hundred-and-seventy-two consecutive dyspeptic outpatients were studied by means of endoscopy (with histology and culture), UBT (75 mg 13C-urea), and serology. Gastritis was classified in accordance with the Sydney criteria. In H. pylori positive patients, the bacterial load was assessed semiquantitatively, the number of bacteria in histologic specimens being counted. UBT results were expressed either as percentage cumulative dose of 13CO2 excreted at 1 h (CD60) or delta over baseline at 30' (DOB30).Of 172 patients, 126 (73%) were H. pylori positive on histology or culture. Using a cut-off value of 3.3/1000 for DOB30, the sensitivity, specificity and accuracy of the UBT were 96%, 93.5%, and 95.3%, respectively. A significant correlation was observed between DOB30 values and intragastric bacterial load (r = 0.32). Moreover, a significant difference in DOB30 values was found between patients sorted by the depth of inflammation (chi(2) = 4.36, p = 0.036). No correlation was observed between DOB30 and endoscopic findings in H. pylori positive subjects.The UBT is an accurate non-invasive diagnostic tool and can be used to predict both the intragastric bacterial load and the severity of related gastritis.
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Spirillaceae
Histology
Microbiological culture
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