A combination of the Helicobacter pylori stool antigen test and urea breath test is useful for clinical evaluation of eradication therapy: a multicenter study.
BACKGROUND
Helicobacter pylori stool antigen (HpSA) test is a new tool for evaluating the H. pylori infection. The present study was carried out to investigate the clinical usefulness of the HpSA test in the evaluation of eradication therapy by comparing it with the (13)C-urea breath test (UBT).


METHODS
One hundred and five patients received eradication therapy for H. pylori. After more than 8 weeks, the success of the therapy was evaluated by the HpSA test and the UBT. Concordant results were regarded as a final diagnosis, but when the results were discordant, histological examination was carried out.


RESULTS
Of the 105 patients receiving eradication therapy for H. pylori, 25 patients were regarded as H. pylori positive by the UBT and and 20 patients were regarded as H. pylori positive by the the HpSA test. Nine patients (8.6%) showed discordant results (seven cases with UBT(+) and HpSA(-), and two with UBT(-) and HpSA(+)). Five cases out of nine were ultimately judged as having a false-positive result of the UBT, and in these cases the UBT values were relatively low (below 10 per thousand). The final diagnostic accuracies of the UBT and the HpSA test were 94.3% (88.0-97.9%; 95% CI) and 97.1% (91.9-99.4%), respectively. When we used the HpSA test in cases with weakly positive UBT values, we were able to diagnose the correct status of H. pylori infection after eradication in 99% of all patients (94.8-100.0%).


CONCLUSIONS
The HpSA test is a useful tool for the evaluation of eradication therapy and a combination of the HpSA test and UBT is clinically recommended.
Ito
Masanori
M
Department of Medicine and Molecular Science, Hirsohima University, Hiroshima 734-8551, Japan. maito@hiroshima-u.ac.jp
Tanaka
Shinji
S
Kim
Sunjin
S
Tahara
Kazumasa
K
Kawamura
Yuzuru
Y
Sumii
Masaharu
M
Takehara
Yoshihiko
Y
Hayashi
Kozo
K
Okamoto
Eiichi
E
Kunihiro
Masaki
M
Kunita
Toshiro
T
Imagawa
Shinobu
S
Takata
Shunsuke
S
Ueda
Hiroyuki
H
Egi
Yasuo
Y
Hiyama
Toru
T
Ueno
Yoshitaka
Y
Kitadai
Yasuhiko
Y
Yoshihara
Masaharu
M
Chayama
Kazuaki
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000942:Antigens, Bacterial / Q000032:analysis*; D001706:Biopsy; D001944:Breath Tests; D002247:Carbon Isotopes; D005243:Feces / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007564:Japan / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014508:Urea / Q000032:analysis
D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial; D002247:Carbon Isotopes; D014508:Urea