title: Performance of routine Helicobacter pylori tests in patients with atrophic gastritis.
abstract: BACKGROUND
  Decreased density of H. pylori in atrophic gastritis may lead to low sensitivity of the routine tests.
  
  
  OBJECTIVE
  To evaluate the accuracy of routinely used H. pylori tests in atrophic gastritis.
  
  
  METHODS
  We compared 5 H. pylori diagnostic tests in 119 dyspeptic patients (28 males/91 females) with a mean age of 67 years (range 55-84). Patients with gastric cancer, peptic ulcer, previous gastric surgery, or those who have received eradication therapy were excluded. The following tests were performed: histology, rapid urease test (RUT), culture, 13C- urea breath tests (UBT), and H.pylori IgG/IgA antibody test (serology).
  
  
  RESULTS
  Atrophic gastritis was diagnosed in 26.1% of the patients; H. pylori was present in 87.1%. In the group with atrophy, the sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy were as follows: histology (100% for all parameters); UBT (96; 100; 100; 80; 97%); serology (96; 50; 93; 67; 90%); culture (96; 100; 100; 80; 97%); and RUT (78; 100; 100; 40; 81%), respectively.
  
  
  CONCLUSIONS
  Histology, UBT and culture were the three best tests for diagnosing H. pylori infection. We cannot recommend using serology as a single test in a case of atrophy, but it would be reasonable to combine serology with one of the above tests.
authors.affiliation: University of Latvia, Faculty of Medicine, Riga, Latvia. dr.sudraba@latnet.lv
authors.forename: Agnese
authors.initials: A
authors.lastname: Sudraba
authors.forename: Ilva
authors.initials: I
authors.lastname: Daugule
authors.forename: Dace
authors.initials: D
authors.lastname: Rudzite
authors.forename: Konrads
authors.initials: K
authors.lastname: Funka
authors.forename: Ivars
authors.initials: I
authors.lastname: Tolmanis
authors.forename: Lars
authors.initials: L
authors.lastname: Engstrand
authors.forename: Dainius
authors.initials: D
authors.lastname: Janciauskas
authors.forename: Laimas
authors.initials: L
authors.lastname: Jonaitis
authors.forename: Gediminas
authors.initials: G
authors.lastname: Kiudelis
authors.forename: Limas
authors.initials: L
authors.lastname: Kupcinskas
authors.forename: Audrius
authors.initials: A
authors.lastname: Ivanauskas
authors.forename: Marcis
authors.initials: M
authors.lastname: Leja
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D001426:Bacterial Proteins / Q000032:analysis; D001431:Bacteriological Techniques; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001706:Biopsy; D001944:Breath Tests; D003955:Diagnostic Tests, Routine; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology* / Q000473:pathology; D005757:Gastritis, Atrophic / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000201:enzymology / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D007844:Latvia; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D012698:Serologic Tests; D014508:Urea / Q000032:analysis; D014510:Urease / Q000032:analysis
chemical_list: D000907:Antibodies, Bacterial; D001426:Bacterial Proteins; D015415:Biomarkers; D014508:Urea; D014510:Urease