title: Diagnostic accuracy of urine Helicobacter pylori antibody test in junior and senior high school students in Japan.
abstract: BACKGROUND
  To prevent gastric cancer, a Helicobacter pylori test-and-treat strategy has been proposed. In Japan, routine urine examinations are performed to screen for kidney diseases; it is therefore convenient to screen for H. pylori infection via urine antibody (u-Ab) testing.
  
  
  OBJECTIVE
  To evaluate the diagnostic accuracy of u-Ab testing in students using13C-urea breath testing (UBT) as a standard.
  
  
  METHODS
  The study population included 806 junior or senior high school students in Japan who provided urine samples and/or underwent UBT. Students with a positive u-Ab test or discrepant results between the u-Ab test and UBT were asked to provide additional stool and/or blood samples or to repeat the UBT. Urinary protein was detected using a urine test strip.
  
  
  RESULTS
  The positive rates for the u-Ab test and UBT were 8.9% (71/795) and 5.5% (44/801), respectively. The u-Ab test showed 88.4% sensitivity and 95.7% specificity using UBT as a standard. In the final diagnoses, the u-Ab test showed 97.6% sensitivity, 96.5% specificity, 61.2% positive predictive value (PPV), and 99.9% negative predictive value (NPV). Of the 508 samples tested using a urine test strip, negative results were obtained for 450 subjects with a sensitivity of 90%, specificity of 97.9%, PPV of 66.7%, and NPV of 99.5%. Proteinuria was detected in 58 samples, with a sensitivity of 100%, specificity of 88.9%, PPV of 40%, and NPV of 100%.
  
  
  CONCLUSIONS
  The u-Ab test is highly accurate and suitable for detecting H. pylori infection. However, the occurrence of proteinuria may yield false-positive results.
authors.affiliation: Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate, Japan.
authors.forename: Katushiro
authors.initials: K
authors.lastname: Mabe
authors.affiliation: Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kikuchi
authors.affiliation: Department of General Medicine and Community Health Science, Sasayama Medical Center, Hyogo College of Medicine, Sasayama, Japan.
authors.forename: Masumi
authors.initials: M
authors.lastname: Okuda
authors.affiliation: Department of Internal Medicine, National Health Insurance Bihoro Hosipital, Bihoro, Japan.
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Takamasa
authors.affiliation: Department of Gastroenterology, National Hospital Organization Hakodate Hospital, Hakodate, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Kato
authors.affiliation: Health Sciences University of Hokkaido, Tobetsu, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
mesh_terms: D000293:Adolescent; D000907:Antibodies, Bacterial / Q000652:urine*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007564:Japan; D008297:Male; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013334:Students
chemical_list: D000907:Antibodies, Bacterial
keywords: gastric cancer prevention; student; urea breath test; urine antibody test