title: Increasing biopsy number and sampling from gastric body improve the sensitivity of rapid urease test in patients with peptic ulcer bleeding.
abstract: BACKGROUND
  Previous studies demonstrated that the sensitivity of rapid urease test (RUT) for diagnosis of Helicobacter pylori infection decreased during peptic ulcer bleeding.
  
  
  OBJECTIVE
  We designed this study and tried to find a better method to improve the detection rate of H. pylori infection at the same session of endoscopic diagnosis of peptic ulcer bleeding.
  
  
  METHODS
  We prospectively enrolled 116 patients with peptic ulcer bleeding. These patients received intravenous proton pump inhibitor and then received upper gastrointestinal endoscopy within 24 h after arrival. We took one piece of biopsy from gastric antrum (Group 1), four pieces from gastric antrum (Group 2), and one piece from the gastric body (Group 3) for three separate RUTs, respectively. (13)C-urease breath test was used as gold standard for diagnosis of H. pylori infection.
  
  
  RESULTS
  There were 74 patients (64 %) with positive (13)C-urease breath test. Among these 74 patients, 45 patients had positive RUT (sensitivity: 61 %) in Group 1; 55 patients had positive RUT (sensitivity: 74 %) in Group 2; 54 patients had positive RUT (sensitivity: 73 %) in Group 3. There were significant differences between Group 1 and Group 2 (p = 0.02) and between Group 1 and Group 3 (p = 0.022).
  
  
  CONCLUSIONS
  The sensitivity of RUT was 61 % during peptic ulcer bleeding. The sensitivity of RUT can be increased significantly by increased biopsy number from gastric antrum or biopsy from gastric body.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, 21, Sec. 2, Nan-Ya South Road, Banciao District, New Taipei City, 22060, Taiwan, thleekimo@yahoo.com.tw.
authors.forename: Tzong-Hsi
authors.initials: TH
authors.lastname: Lee
authors.forename: Chien-Chu
authors.initials: CC
authors.lastname: Lin
authors.forename: Chen-Shuan
authors.initials: CS
authors.lastname: Chung
authors.forename: Cheng-Kuan
authors.initials: CK
authors.lastname: Lin
authors.forename: Cheng-Chao
authors.initials: CC
authors.lastname: Liang
authors.forename: Kuang-Chau
authors.initials: KC
authors.lastname: Tsai
mesh_terms: D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D001706:Biopsy / Q000379:methods*; D001944:Breath Tests; D002245:Carbon Dioxide / Q000378:metabolism; D002247:Carbon Isotopes; D004381:Duodenal Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000201:enzymology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D013276:Stomach Ulcer / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D013997:Time Factors; D014508:Urea; D014510:Urease / Q000378:metabolism*
chemical_list: D000897:Anti-Ulcer Agents; D001426:Bacterial Proteins; D015415:Biomarkers; D002247:Carbon Isotopes; D054328:Proton Pump Inhibitors; D002245:Carbon Dioxide; D014508:Urea; D014510:Urease