Polymerase chain reaction: a sensitive method for detecting Helicobacter pylori infection in bleeding peptic ulcers.
OBJECTIVE
To assess the sensitivity and specificity of polymerase chain reaction (PCR) in detecting Helicobacter pylori (H pylori) infection in patients with bleeding peptic ulcers, and to compare its diagnostic efficacy with other invasive and non-invasive tests.


METHODS
From April to September 2002, H pylori status in 60 patients who consecutively presented with gastroduodenal ulcer bleeding was examined by rapid urease tests (RUT), histology, culture, PCR, serology and urea breath tests (UBT).


RESULTS
The sensitivity of PCR was significantly higher than that of RUT, histology and culture (91% vs 66%, 43% and 37%, respectively; P = 0.01, <0.001, <0.001, respectively), but similar to that of serology (94%) and UBT (94%). Additionally, PCR exhibited a greater specificity than serology (100% vs 65%, P<0.01). However, the specificity of PCR did not differ from that of other tests. Further analysis revealed significant differences in the sensitivities of RUT, culture, histology and PCR between the patients with and those without blood in the stomach (P<0.01, P = 0.09, P<0.05, and P<0.05, respectively).


CONCLUSIONS
PCR is the most accurate method among the biopsy-based tests to detect H pylori infection in patients with bleeding peptic ulcers. Blood may reduce the sensitivities of all biopsy-based tests.
Lo
Ching-Chu
CC
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan, China.
Lai
Kwok-Hung
KH
Peng
Nan-Jing
NJ
Lo
Gin-Ho
GH
Tseng
Hui-Hwa
HH
Lin
Chiun-Ku
CK
Shie
Chang-Bih
CB
Wu
Chao-Ming
CM
Chen
Yu-Shan
YS
Huang
Wen-Keui
WK
Chen
Angela
A
Hsu
Ping-I
PI
D000368:Aged; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000150:complications* / Q000382:microbiology*; D016133:Polymerase Chain Reaction / Q000592:standards*; D012680:Sensitivity and Specificity