Is the Remarkable Contradiction between Histology and 14C Urea Breath Test in the Detection of Helicobacter pylori due to False-negative Histology or False-positive 14C Urea Breath Test?

2005 ◽  
Vol 33 (6) ◽  
pp. 632-640 ◽  
Author(s):  
AK Gurbuz ◽  
AM Ozel ◽  
Y Narin ◽  
Y Yazgan ◽  
H Baloglu ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
False Positive ◽  
Breath Test ◽  
False Negative ◽  
Urea Breath Test ◽  
Predictive Values ◽  
Urease Test ◽  
H Pylori ◽  
Micro Organisms ◽  
Positive Results

We assessed the diagnostic value of the 14C urea breath test (UBT) in the detection of Helicobacter pylori compared with histology and the rapid urease test (RUT). The study included 68 patients (22 men and 46 women) with dyspeptic symptoms. H. pylori status was evaluated by 14C UBT, RUT and histology. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were determined for 14C UBT and for RUT. Histology revealed dense yeast-like micro-organisms in the biopsy specimens in all patients with false-positive results by 14C UBT (n = 8), a significantly higher proportion than in patients with negative 14C UBT (five of 31). The low specificity of the H. pylori14C UBT should not be neglected by accepting histology results as false-negative. Gastric mucosal colonization by yeast-like micro-organisms with urease activity can account for the high frequency of false-positive results for 14C UBT.

scholarly journals 13C Urea Breath Test for Helicobacter pylori: Determination of the Optimal Cut-Off Point in a Canadian Community Population

2006 ◽  
Vol 20 (12) ◽  
pp. 770-774 ◽  
Author(s):  
Marina Mauro ◽  
Vladimir Radovic ◽  
Pengfei Zhou ◽  
Melanie Wolfe ◽  
Markad Kamath ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
False Positive ◽  
Breath Test ◽  
False Negative ◽  
Urea Breath Test ◽  
Noninvasive Test ◽  
Negative Results ◽  
False Negative Results ◽  
Community Population ◽  
H Pylori

AIM: To determine the test characteristics and the optimal cut-off point for the 13C urea breath test (13C UBT) in a Canadian community laboratory setting.METHODS: Of 2232 patients (mean age ± SD: 51±21 years, 56% female) who completed a 13C UBT, 1209 were tested to evaluate the primary diagnosis of Helicobacter pylori infection and 1023 were tested for confirmation of eradication following treatment. Cluster analysis was performed on the 13C UBT data to determine the optimal cut-off point and the risk of false-positive and false-negative results. Additionally, 176 patients underwent endoscopic biopsy to allow validation of the sensitivity and specificity of the 13C UBT against histology and microbiology using the calculated cut-off point.RESULTS: The calculated cut-off points were 3.09 δ‰ for the whole study population (n=2232), 3.09 δ‰ for the diagnosis group (n=1209) and 2.88 δ‰ for the post-treatment group (n=1023). When replacing the calculated cut-off points by a practical cut-off point of 3.0 δ‰, the risk of false-positive and false-negative results was lower than 2.3%. The 13C UBT showed 100% sensitivity and 98.5% specificity compared with histology and microbiology (n=176) for the diagnosis of active H pylori infection.CONCLUSIONS: The 13C UBT is an accurate, noninvasive test for the diagnosis of H pylori infection and for confirmation of cure after eradication therapy. The present study confirms the validity of a cutoff point of 3.0 δ‰ for the 13C UBT when used in a large Canadian community population according to a standard protocol.

scholarly journals DIAGNOSTIC ACCURACY OF UREA BREATH TEST FOR HELICOBACTER PYLORI INFECTION IN CHILDREN WITH DYSPEPSIA IN COMPARISON TO HISTOPATHOLOGY

2016 ◽  
Vol 53 (2) ◽  
pp. 108-112 ◽  
Author(s):  
Naser HONAR ◽  
Alireza MINAZADEH ◽  
Nader SHAKIBAZAD ◽  
Mahmood HAGHIGHAT ◽  
Forough SAKI ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Carbon Isotope ◽  
Sensitivity And Specificity ◽  
Breath Test ◽  
Close Association ◽  
Urea Breath Test ◽  
Helicobacter Pylori Infection ◽  
Cross Sectional ◽  
Predictive Values ◽  
H Pylori

ABSTRACT Background - Helicobacter pylori infection is the gram negative bacillus with the close association with chronic antral gastritis. Objective - In this study, we evaluate the accuracy of urea breath test (UBT) with carbon isotope 13 in comparison with histopathology of gastric antrum for detection of H. pylori infection in children with dyspepsia. Methods - This cross-sectional study was performed at specialized laboratory of Shiraz Gastroenterohepatology Research Center and Nemazee Hospital, Iran, during a 12-months period. This study investigated the sensitivity, specificity, and positive and negative predictive values of UBT in comparison with biopsy-based tests. We included a consecutive selection of 60 children who fulfilled Rome III criteria for dyspepsia. All children were referred for performing UBT with carbon isotope 13 (C13) as well as endoscopy. Biopsies were taken from antrum of stomach and duodenum. The pathologic diagnosis was considered as the standard test. Results - The mean age of the participants was 10.1±2.6 (range 7-17 years). From our total 60 patients, 28 (46.7%) had positive UBT results and 32 (53.3%) had negative UBT results. Pathologic report of 16 (57.1%) out of 28 patients who had positive UBT were positive for H. pylori and 12 (42.9%) ones were negative. Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Conclusion - Sensitivity and specificity of C13-UBT for detection of H. pylori infection were 76.2% and 69.2% respectively. Another multicenter study from our country is recommended.

The Clinical Efficacy of Helicobacter pylori Eradication in Patients with Helicobacter pylori-Positive Chronic Thrombocytopenic Purpura.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4002-4002 ◽  
Author(s):  
Seung-Hyun Nam ◽  
Bong-Seog Kim ◽  
Jae Hoon Lee ◽  
Hong Suk Song ◽  
Sung-Hwa Bae ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Platelet Count ◽  
Breath Test ◽  
Urea Breath Test ◽  
Rapid Urease Test ◽  
Thrombocytopenic Purpura ◽  
Platelet Recovery ◽  
Chronic Itp ◽  
Urease Test ◽  
H Pylori

Abstract Background: Helicobacter pylori (H pylori) has been implicated in the pathogenesis of some autoimmune diseases including idiopathic thrombocytopenic purpura (ITP). Several studies recently showed a high prevalence of H pylori infection in patients with ITP and reported a platelet recovery after bacterial eradication therapy. The prevalence of H pylori infection and effect of its eradication in Korea patients with chronic ITP were investigated. Methods: The study included among 35 patients with chronic ITP from eight hospitals. H pylori infection was assessed by urea breath test, rapid urease test or microbial culture. H pylori eradication was performed with amoxicillin, clarithromycin and omeprazol regimen for 7 days or bismuth, metronidazol and tetracycline regimen for 10 days. Eradication was assessed by urea breath test 4 weeks after treatment. Platelet counts were monitored serially after the end of treatment. Results: Thirty five patients with chronic ITP were evaluated, including 12 males and 23 females. Median age was 57 years (range 30–79). The median platelet count before eradication was 23,000/uL (range 4,000–66,000/uL). Sixteen patients were performed the splenectomy previously. H pylori infection was found in 23 (65%) of 35 patients. In 21 patients performed the eradication, 6 patients (28.5%) had a significant increase in platelet count after 2 weeks and 2 months. The response duration was 1–27 (median 7.6) months. Conclusions: This study confirmed the efficacy of H pylori eradication in increasing platelet in adult chronic ITP patients. We must consider the investigation and eradication of H pylori infection in ITP patients as a simple, inexpensive tool in management of the chronic disease.

scholarly journals Evaluation of invasive and non-invasive methods for the diagnosis of Helicobacter pylori infection in symptomatic children and adolescents

2001 ◽  
Vol 119 (2) ◽  
pp. 67-71 ◽  
Author(s):  
Silvio Kazuo Ogata ◽  
Elisabete Kawakami ◽  
Francy Reis Silva Patrício ◽  
Margareth Zabeu Pedroso ◽  
Antonio Mario Santos
Keyword(s):  
Helicobacter Pylori ◽  
Children And Adolescents ◽  
Breath Test ◽  
Urea Breath Test ◽  
Diagnostic Methods ◽  
Helicobacter Pylori Infection ◽  
Rapid Urease Test ◽  
Predictive Values ◽  
Non Invasive ◽  
Urease Test

CONTEXT: Multiple diagnostic methods are available for the detection of Helicobacter pylori infection, but at present no single one can be used as the gold standard. OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of 3 invasive and 2 non-invasive methods for detection of Helicobacter pylori infection in symptomatic children and adolescents. DESIGN: Prospective cohort study SETTING: Peptic Disease outpatients service, Discipline of Pediatric Gastroenterology, Universidade Federal de São Paulo / Escola Paulista de Medicina. PATIENTS: Forty-seven patients who underwent endoscopy because of dyspeptic symptoms. DIAGNOSTIC METHODS: Endoscopy with gastric biopsies for 3 invasive (rapid urease test, histology and culture) and 2 non-invasive methods (a commercial ELISA serology and 13carbon urea breath test - isotope ratio mass spectrometry) for detection of Helicobacter pylori infection. MAIN MEASUREMENTS: Sensitivity, specificity, positive and negative predictive values of each method and agreement and disagreement rates between the methods. RESULTS: Forty-seven patients [mean age, 11y9mo (SD 2y10mo), 27 female and 20 male]; 62% of them were Helicobacter pylori-positive. All methods agreed in 61%, and were negative in 21% and positive in 40%. The greatest concordance between 2 methods occurred between the invasive methods: histology and rapid urease test (89.6%) and histology and culture (87.5%). The greatest sensitivity, considering Helicobacter pylori-positive cases, for any combination of 3 or more tests, was achieved by the rapid urease test (S=100%), followed by histology, serology and 13carbon-urea breath test (S=93.1%) and lastly by culture (S=79.3%). The highest specificity was obtained by histology (100%) and culture (100%), followed by the rapid urease test (84.2%), serology (78.9%) and 13carbon-urea breath test (78.9%). CONCLUSIONS: Our results suggest that among invasive methods, an association between the rapid urease test and histology constituted the best choice for the detection of Helicobacter pylori infection. If results of histology and the rapid urease test are different, serology may be recommended.

scholarly journals Comparison of Two Rapid Whole-Blood Tests for Helicobacter pylori Infection in Chinese Patients

1998 ◽  
Vol 36 (11) ◽  
pp. 3441-3442 ◽  
Author(s):  
Wai Keung Leung ◽  
Francis K. L. Chan ◽  
Matthew S. Falk ◽  
Roamy Suen ◽  
Joseph J. Y. Sung
Keyword(s):  
Helicobacter Pylori ◽  
Whole Blood ◽  
Urea Breath Test ◽  
Chinese Patients ◽  
Rapid Urease Test ◽  
Predictive Values ◽  
Blood Tests ◽  
Urease Test ◽  
One Step ◽  
H Pylori

Consecutive Chinese patients undergoing endoscopy for dyspepsia were tested for Helicobacter pylori infection by two rapid whole-blood tests: FlexPack HP (Abbott Laboratories) and Helisal One-Step (Cortecs Diagnostics). Biopsy-based tests (rapid urease test and histology) and the [13C]urea breath test were used as the “gold standard.” One hundred sixty-one consecutive patients were studied, and 88 (54.7%) were confirmed to have H. pylori infection. The sensitivities, specificities, and positive and negative predictive values were 81.8%, 83.6% (P= 0.008), 85.7% (P = 0.04), and 79.2% for FlexPack HP and 84.1%, 63.0% (P = 0.008), 73.3% (P = 0.047), and 76.7% for Helisal One-Step, respectively.

scholarly journals DIAGNOSTIC ACCURACY OF C-14 UREA BREATH TEST FOR DETECTION OF HELICOBACTER PYLORI IN PATIENTS WITH GASTRITIS

2021 ◽  
Vol 71 (4) ◽  
pp. 1231-34
Author(s):  
Zaigham Salim Dar ◽  
Suniya Arshad Butt ◽  
Khurram Hayat Mir ◽  
Fida Hussain
Keyword(s):  
Helicobacter Pylori ◽  
Diagnostic Accuracy ◽  
Breath Test ◽  
False Negative ◽  
Armed Forces ◽  
Endoscopic Biopsy ◽  
Urea Breath Test ◽  
Helicobacter Pylori Infection ◽  
True Negative ◽  
Predictive Values

Objective: To evaluate the diagnostic accuracy of C-14 Urea Breath Test for detection of helicobacter pylori infection in patients with gastritis. Study Design: Cross-sectional validation study. Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Feb to Aug 2016. Methodology: After fulfilling inclusion and exclusion criteria, 110 patients of both genders, aged between 18-50 years, were enrolled. Prior written informed consent was obtained from each patient. First, they were assessed by C-14 Urea Breath Test, followed by endoscopic biopsy and histopathology. Results of C-14 Urea Breath Test were compared to histopathology diagnosis which was taken as gold standard. Results: Patients’ ages ranged from 18-50 years with a mean ± SD of 37.45 ± 10.21 years. Seventy four (67.3%) of them were males and 36 (32.7%) were females. Sixty four (58.2%) patients were suspected of helicobacter pylori on C-14 Urea breath test. However, histopathology of endoscopic biopsy confirmed helicobacter pylori in 66 (60%) patients yielding 64 true positive, 44 true negative and 2 false negative cases. Calculated sensitivity was 96.97%, specificity 100% and accuracy was 98.18% for C-14 Urea Breath Test with negative and positive predictive values of 95.65% and 100% respectively. Conclusion: C-14 Urea Breath Test is highly accurate, sensitive and specific test for detection of helicobacter pylori infection, irrespective of patient’s age and gender.

scholarly journals Occult H. pylori infection partially explains ‘false‐positive’ results of 13 C‐urea breath test

2015 ◽  
Vol 3 (5) ◽  
pp. 437-442 ◽  
Author(s):  
María J Ramírez-Lázaro ◽  
Sergio Lario ◽  
Xavier Calvet ◽  
Jordi Sánchez-Delgado ◽  
Antònia Montserrat ◽  
...  
Keyword(s):  
False Positive ◽  
Breath Test ◽  
Urea Breath Test ◽  
H Pylori ◽  
Positive Results

scholarly journals Correlation between Quantitative 13C-Urea Breath Test and Helicobacter pylori Treatment Success in a Population-Based Cohort

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Doron Boltin ◽  
Zohar Levi ◽  
Tsachi Tsadok Perets ◽  
Hemda Schmilovitz-Weiss ◽  
Rachel Gingold-Belfer ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Breath Test ◽  
Treatment Success ◽  
Population Based ◽  
Urea Breath Test ◽  
First Line Therapy ◽  
13C Urea Breath Test ◽  
Helicobacter Pylori Treatment ◽  
H Pylori ◽  
First Time

Background. There are continual efforts to identify factors which influence the success of first-line therapy for Helicobacter pylori (H. pylori) infection. The 13C-urea breath test result (C13-UBT) utilizes H. pylori urease activity and is a highly accurate diagnostic assay. We aimed to determine whether the magnitude of C13-UBT result is related to treatment success. Methods. Adult patients who underwent a first-time 13C-urea breath test between January 2010 and January 2016 were included. In order to isolate a naïve test-and-treat population who were unlikely to have undergone an initial endoscopy-based H. pylori test, we excluded patients > 45 years and those with a previous C13-UBT. Data were extracted from the Clalit Health Services laboratory database. Results. A total of 94,590 subjects (36.1% male, age 28.5 ± 6.0 years) who underwent a first-time C13-UBT during the study period were included. C13-UBT was positive in 48,509 (51.3%) subjects. A confirmatory posttreatment C13-UBT was performed in 18,375 (37.8%), and eradication was successful in 12,018 (65.4%). The mean C13-UBT recording was 20.6 ± 16.2 DOB in subjects with successful eradication and 19.5 ± 13.1 DOB in subjects with treatment failure (OR, 1.01; 95% CI 1.00-1.01, p<0.01). Among patients in the upper quintile of C13-UBT measurement, eradication was achieved in 67.6%, compared to 62.6% in the lower quintile (OR, 1.22; 95% CI 1.11-1.35, p<0.01). Subjects in the top 1 percentile (C13-UBT ≥ 70 DOB) achieved eradication in 75.0%, compared to 65.3% among subjects with C13-UBT < 70 DOB (OR, 1.59; 95% CI 1.05-2.41, p<0.01). Conclusions. The superiority in H. pylori eradication observed in subjects with a higher C13-UBT DOB is small but significant. Further studies should examine the physiological and microbiological basis for this finding.

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