Comparison of 13C-urea breath test values in gastric cancer, peptic ulcer and gastritis.
OBJECTIVE
Results of urea breath test (UBT) are related to the severity of atrophic gastritis and the density of Helicobacter pylori (H. pylori). Recently, it has been reported that low UBT values should be considered to suggest the possibility of gastric cancer. This study compares UBT results in gastric cancer patients with those of peptic ulcer and gastritis patients.


METHODS
Between October 1998 and May 2000, we have consecutively collected 564 H. pylori-positive patients: 128 gastritis patients, 72 gastric cancer patients, 64 gastric ulcer patients and 300 duodenal ulcer patients. Peptic ulcers were classified into active (A), healing (H), and scar (S) stages. Gastric cancer was classified into early stage (EGCA) and advanced stage (AGCA). The dose of 13C-urea was 50mg, and breath samples were analyzed with a mass spectrometer and the data was evaluated by Mann-Whitney test. The cut-off value was 3.5 per thousand.


RESULTS
The mean UBT values of gastric cancer, gastric ulcer (GU), duodenal ulcer (DU) and gastritis were 16.95 +/- 12.2 per thousand, 16.3 +/- 9.3 per thousand, 15.13 +/- 9.9 per thousand and 20.07 +/- 13.5 per thousand. There were no significant differences in UBT values between gastric cancer and gastric ulcer (p = 0.745), duodenal ulcer (p = 0.3831), or gastritis (p = 0.2953). There were also no significant differences between subgroups of gastric cancer and gastric ulcer. There were significantly higher UBT values in the DU scar stage (p = 0.001) and healing stage (p = 0.0484) than in the active stage.


CONCLUSIONS
We conclude that the UBT value is not a good method for the prediction of gastric cancer. In addition, based on the results of our study, the UBT values may explain the relationship between the natural course of duodenal ulcer and H. pylori infection.
Tseng
Chang-An
CA
Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Dalin Chia-Yi, Taiwan.
Wu
Jeng-Yih
JY
Pan
Yong-Sang
YS
Yu
Fang-Jong
FJ
Kuo
Chao-Hung
CH
Lu
Chien-Yu
CY
Su
Yu-Chung
YC
Wu
Deng-Chyang
DC
Perng
Daw-Shyong
DS
Jan
Chang-Ming
CM
Wang
Wen-Ming
WM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests; D002247:Carbon Isotopes; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D005756:Gastritis / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis; D013274:Stomach Neoplasms / Q000175:diagnosis*; D014508:Urea
D002247:Carbon Isotopes; D014508:Urea