title: Studies of 13C-urea breath test for diagnosis of Helicobacter pylori infection in patients after partial gastrectomy.
abstract: OBJECTIVE
  Many of the reports on the diagnostic efficacy of the 13C-urea breath test (13C-UBT) for the detection of Helicobacter pylori in the residual stomach have shown negative results. We conducted an evaluation to establish a standardized protocol and an appropriate cutoff value for 13C-UBT in partial gastrectomy patients.
  
  
  METHODS
  Forty-two patients undergoing partial gastrectomy were included. Three gastric biopsies from the anastomotic site and mid-to-high body were taken at panendoscopy for histology, culture and rapid urease test (RUT). The 13C-UBT protocol included ingestion of 100 mg 13C-urea, use of mouthwash, and the body in a horizontal position on the left side. Six breath samples were taken after ingestion.
  
  
  RESULTS
  The Delta 13CO2 values were significantly elevated in infected patients at all time points, and values were higher at 20 min and thereafter than at an earlier time point. The sensitivity of 13C-UBT was 96.3% with the cutoff of 2.0 per thousand at 40 min. The accuracy rates were highest with 13C-UBT, culture, RUT and histological tests, in that order.
  
  
  CONCLUSIONS
  Forty minutes and a cutoff of 2.0 per thousand were found to be optimal for the test, with the body position horizontal on the left side. In the present protocol 13C-UBT appears to be a reliable tool with the same accuracy rate as other routine tests in patients with a remnant stomach.
authors.affiliation: Department of Gastrointestinal Surgery, University of Tokyo, Japan. kubotak-dis@h.u-tokyo.ac.jp
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kubota
authors.forename: Shouji
authors.initials: S
authors.lastname: Shimoyama
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimizu
authors.forename: Chiaki
authors.initials: C
authors.lastname: Noguchi
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Mafune
authors.forename: Michio
authors.initials: M
authors.lastname: Kaminishi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tange
mesh_terms: D001706:Biopsy; D001944:Breath Tests; D002247:Carbon Isotopes; D005260:Female; D005743:Gastrectomy; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011187:Posture; D012680:Sensitivity and Specificity; D013270:Stomach / Q000473:pathology; D014508:Urea
chemical_list: D002247:Carbon Isotopes; D014508:Urea