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.
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.
Lahner
Edith
E
Digestive and Liver Disease Unit, II Medical School, University La Sapienza, Rome, Italy.
Vaira
Dino
D
Figura
Natale
N
Pilozzi
Emanuela
E
Pasquali
Amelia
A
Severi
Carola
C
Perna
Federico
F
Delle Fave
Gianfranco
G
Annibale
Bruno
B
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
D000942:Antigens, Bacterial; D001399:Azure Stains; D002247:Carbon Isotopes; D014508:Urea