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Simplified 13 C‐urea breath test with a new infrared spectrometer for diagnosis of Helicobacter pylori infection
Author(s) -
CHEN TSENGSHING,
CHANG FULLYOUNG,
CHEN PANGCHI,
HUANG THOMAS W,
OU JONATHAN T,
TSAI MINGHUNG,
WU MINGSHIANG,
LIN JAWTOWN
Publication year - 2003
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1046/j.1440-1746.2003.03139.x
Subject(s) - breath test , medicine , helicobacter pylori , gastroenterology , cutoff , receiver operating characteristic , rapid urease test , biopsy , nuclear medicine , helicobacter pylori infection , physics , quantum mechanics
Background and Aim: Infrared spectrometry has correlated excellently with mass spectrometry in detecting the ratio of 13 CO 2 to 12 CO 2 in breath samples. The present study aimed to evaluate the accuracy of the 13 C‐urea breath test ( 13 C‐UBT) using a new model of infrared analyzer. Methods: A total of 600 patients who were undergoing upper endoscopy without receiving eradication therapy were entered into the study. Culture, histology, and rapid urease test on biopsies from the antrum and corpus of the stomach were used for the determination of Helicobacter pylori infection . Breath samples were collected before and 20 min after drinking 100 mg 13 C‐urea in 100 mL water. The optimal cutoff value was determined by the receiver operating characteristic curve. Results: Of the 586 patients who were eligible for analysis, 369 were positive for H. pylori infection, 185 were negative for H. pylori infection, and 32 were indeterminate. When the appropriate cutoff value was set at 3.5‰, a sensitivity of 97.8%, a specificity of 96.8% and an accuracy of 97.5% were obtained using the 13 C‐UBT. The accuracy of the 13 C‐UBT decreased when CO 2 concentration in the breath sample was <2%, as compared with ≥2% (93.6% vs 97.7%), mainly because of a decrease in specificity (81.8% vs 97.7%). There were 2.7% of patients with Δ 13 CO 2 values that fell between 3.0–4.5‰, in whom the risk of error was 47%. Conclusions: The 13 C‐UBT performed with infrared spectrometry is a highly sensitive, specific, and non‐invasive method for the detection of H. pylori infection. The immediate availability of the test result and technical simplicity make it particularly effective in routine clinical practice.