Evaluation for reliability of 13C-Urea breath test and other biopsy-based methods in H. pylori diagnosis

ABSTRACT

Multiple tests are available to diagnose Helicobacter pylori. The aim of this study was to evaluate and compare the sensitivity, specificity and negative and positive predictive values of 13C-Urea breath test (13C-UBT) and other biopsy-based methods in H. pylori diagnosis. A total of 702 patients (mean age, 51.2+/-16.0 years; 327 males and 375 females) were tested for H. pylori infection using 13C-UBT, CLO tests (Delta West, Australia), histology (H&E and modified Giemsa stains), and culture. All patients were untreated for H. pylori infection. Infection status was established by Gold Standard (or culture positive of 2 out of 3 other tests positive). Results suggested that 13C-UBT was the most accurate method for H. pylori diagnosis, although CLO test and histology also produced excellent sensitivity and specificity. Culture method had the best specificity; however, it produced the lowest sensitivity. Combination of histology and CO test gave higher sensitivity and specificity than each method used individually. Conclusion: The noninvasive 13C-BUT is excellent accurate method for determining H. pylori infection when endoscopy is not required. Histology, CLO test and culture are also good methods for H. pylori diagnosis.