The role of 14C-labelled urea breath test in the diagnosis of Helicobacter pylori infection

ABSTRACT

Helicobacter pylori infection is the most common infection causing gastritis, peptic ulcer disease, non-ulcer dyspepsia and gastric carcinoma. Diagnostic methods used to determine infection include blood antibody test, stool antigen test, urea breath test and endoscopy. Endoscopy with biopsy is the most reliable procedure, but is associated with several major adverse events including perforation, bleeding and infection.OBJECTIVE: This study aimed to determine the value of 14C-labelled urea breath test in the diagnosis of H. pylori infection, and to determine its sensitivity, specificity, positive and negative predictive values, and accuracy.METHODS: From January to December 2007, 34 subjects were recruited from a tertiary hospital in Metro Manila. All of them underwent both urea breath test and endoscopy. Statistical analysis was performed using endoscopy as the gold standard.RESULTS:The sensitivity and specificity of urea breath test were 90% and 91 %, respectively. Endoscopy with biopsy, histopathologic analysis and rapid urease test is still the gold standard, but it should not be the first procedure to be requested because of the complications associated with this invasive procedure.CONCLUSION: 14C-labelled urea breath test is the safest, fastest, the most non-invasive and therefore the best screening test in the diagnosis of Helicobacter pylori infection.