title: Role of noninvasive tests (C-urea breath test and stool antigen test) as additional tools in diagnosis of Helicobacter pylori infection in patients with atrophic body gastritis.
abstract: BACKGROUND
  Detection of Helicobacter pylori infection in atrophic body gastritis (ABG) is difficult, as during progression of body atrophy, H. pylori disappears.
  
  
  OBJECTIVE
  To increase the diagnostic yield of detection of active H. pylori infection in atrophic body gastritis patients by using noninvasive tests such as (13)C-Urea Breath Test ((13)C-UBT) and H. pylori stool antigen test (HpSA) would be useful.
  
  
  METHODS
  27 consecutive patients with newly-diagnosed atrophic body gastritis (19F/7M, age 27-73 years).
  
  
  METHODS
  Gastroscopy with biopsies (antrum n = 3, body n = 3) and histology according to updated Sydney system, H. pylori IgG serology, (13)C-UBT, and HpSA.
  
  
  RESULTS
  All tests used in the diagnosis of H. pylori infection were in agreement in 9/27 atrophic body gastritis patients (33.3%), being all positive in four (14.8%) and all negative in five patients (18.5%). Ten of the 27 (37%) patients were Giemsa stain-positive and serology-positive (group I). Seventeen of the 27 (63%) patients were Giemsa stain-negative: 5/17 with positive serology (group II) and 12/17 with negative serology (group III). In group I, 5/10 (50%) were (13)C-UBT positive and 4/10 (40%) HpSA positive. In group II, two patients were (13)C-UBT positive, but all were HpSA negative. Also in group III, all patients were HpSA negative, but one had a positive (13)C-UBT.
  
  
  CONCLUSIONS
  In atrophic body gastritis patients, neither (13)C-UBT nor HpSA per se add useful information regarding active H. pylori infection, but these noninvasive tests may be important in combination with histology and serology to define the H. pylori status in some atrophic body gastritis patients.
authors.affiliation: Digestive and Liver Disease Unit, II Medical School, University La Sapienza, Rome, Italy.
authors.forename: Edith
authors.initials: E
authors.lastname: Lahner
authors.forename: Dino
authors.initials: D
authors.lastname: Vaira
authors.forename: Natale
authors.initials: N
authors.lastname: Figura
authors.forename: Emanuela
authors.initials: E
authors.lastname: Pilozzi
authors.forename: Amelia
authors.initials: A
authors.lastname: Pasquali
authors.forename: Carola
authors.initials: C
authors.lastname: Severi
authors.forename: Federico
authors.initials: F
authors.lastname: Perna
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Delle Fave
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000032:analysis*; D001399:Azure Stains; D001706:Biopsy; D001944:Breath Tests; D002247:Carbon Isotopes; D004797:Enzyme-Linked Immunosorbent Assay; D005243:Feces / Q000382:microbiology; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005757:Gastritis, Atrophic / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014508:Urea
chemical_list: D000942:Antigens, Bacterial; D001399:Azure Stains; D002247:Carbon Isotopes; D014508:Urea