Evaluation of Helicobacter pylori diagnostic methods in patients with liver cirrhosis.
BACKGROUND
Helicobacter pylori-associated peptic ulcer is a frequent complication in cirrhotic patients and its morbidity rate is high. In spite of this, diagnostic methods for H. pylori infection have not been fully evaluated in these patients.


OBJECTIVE
To evaluate H. pylori diagnostic methods in patients with liver cirrhosis.


METHODS
One hundred and one cirrhotic patients were included in the study. Three antral and two corpus biopsies were obtained for rapid urease test of the antral mucosa, and Giemsa stain and immunohistochemistry were performed for both the corpus and antrum. Serology, 13C-urea breath test and faecal H. pylori antigen determination were also carried out.


RESULTS
Sixty-two patients were positive and 35 were negative for H. pylori infection; four were indeterminate. The sensitivity and specificity were 90.4% and 100%, respectively, for antral histology, 100% and 100% for gastric body histology, 90.4% and 100% for antral immunohistochemistry, 96.2% and 96.7% for body immunochemistry, 85.7% and 97% for rapid urease test, 83.6% and 55.9% for serology, 96.4% and 97.1% for 13C-urea breath test and 75.4% and 94.1% for faecal antigen.


CONCLUSIONS
The most reliable tests for H. pylori infection in cirrhotic patients were the 13C-urea breath test and gastric body histology.
Calvet
X
X
Digestive Diseases Unit, Corporació Parc Taulí, Sabadell, Barcelona, Spain. xcalvet@cspt.es
Sanfeliu
I
I
Musulen
E
E
Mas
P
P
Dalmau
B
B
Gil
M
M
Bella
M R
MR
Campo
R
R
Brullet
E
E
Valero
C
C
Puig
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques; D001706:Biopsy; D001944:Breath Tests; D005260:Female; D005756:Gastritis / Q000382:microbiology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D016013:Likelihood Functions; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013270:Stomach / Q000473:pathology