Dual specimens increase the diagnostic accuracy and reduce the reaction duration of rapid urease test.
OBJECTIVE
To evaluate the influence of multiple samplings during esophagogastroduodenoscopy (EGD) on the accuracy of the rapid urease test, and the validity of newly developed rapid urease tests, HelicotecUT plus test and HelicotecUT test, CLO test and ProntoDry test.


METHODS
A total of 355 patients undergoing EGD for dyspepsia were included. Their Helicobacter pylori (H. pylori) treatment status was either naïve or eradicated. Six biopsy specimens from antrum and gastric body, respectively, were obtained during EGD. Single antral specimens and dual (antrum + body) specimens were compared. Infection status of H. pylori was evaluated by three different tests: culture, histology, and four different commercially available rapid urease tests (RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test, and established CLO test and ProntoDry test. H. pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology, CLO test and ProntoDry test.


RESULTS
When dual specimens were applied, sensitivity was enhanced and RUT reaction time was significantly reduced, regardless of their treatment status. Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs. Both newly developed RUTs showed comparable sensitivity, specificity and accuracy to the established RUTs, regardless of patient treatment status, RUT reaction duration, and EGD biopsy sites.


CONCLUSIONS
Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.
Hsu
Wen-Hung
WH
Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan, China.
Wang
Sophie-Sw
SS
Kuo
Chao-Hung
CH
Chen
Chiao-Yun
CY
Chang
Ching-Wen
CW
Hu
Huang-Ming
HM
Wang
Jaw-Yuan
JY
Yang
Yuan-Chieh
YC
Lin
Yu-Chun
YC
Wang
Wen-Ming
WM
Wu
Deng-Chyang
DC
Wu
Ming-Tsang
MT
Kuo
Fu-Chen
FC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000201:enzymology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000201:enzymology / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011933:Reagent Kits, Diagnostic; D015203:Reproducibility of Results; D014510:Urease / Q000378:metabolism*; D055815:Young Adult
D011933:Reagent Kits, Diagnostic; D014510:Urease