Usefulness of the 14C urea breath test as a semi-quantitative monitoring instrument after therapy for Helicobacter pylori infection.
BACKGROUND
We evaluated the reliability and usefulness of the 14C urea breath test (UBT) in confirming eradication of Helicobacter pylori 4 to 6 weeks after cessation of antimicrobial therapy.


METHODS
We investigated 57 patients, who underwent both an upper endoscopy with multiple biopsy specimens taken for histopathology, culture and/or CLO test, and a 14C UBT. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the breath test were calculated against the combined biopsy-based test results. Values for sensitivity, specificity, PPV, and NPV were also calculated after excluding results in a grey zone containing equivocal test results.


RESULTS
Sensitivity, specificity, PPV, and NPV of the 14C UBT were 92%, 78%, 52%, and 97%, respectively. After introduction of a grey zone concept, these values were 89%, 100%, 100%, and 97% respectively.


CONCLUSIONS
We conclude that for research, upper gastrointestinal endoscopy with multiple biopsy specimens and using different diagnostic techniques should remain the 'gold standard' to test for cure.
van de Wouw
B A
BA
Dept. of Internal Medicine, Sint Anna Hospital, Oss, The Netherlands.
de Boer
W A
WA
Hermsen
H W
HW
Valkenburg
J G
JG
Geuskens
L M
LM
Tytgat
G N
GN
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001706:Biopsy; D001944:Breath Tests / Q000379:methods; D002250:Carbon Radioisotopes; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014508:Urea
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D002250:Carbon Radioisotopes; D014508:Urea