Clinical Efficacy of the 13C-Urea Breath Test for the Diagnosis of Helicobacter pylori Infection

Shim, Chan Sup; Lee, Joon Seong; Kim, Yun Soo; Lee, Moon Sung; Cho, Joo Young; Hwang, Seong Gyu; Cho, Young Deok; Hong, Su Jin; Moon, Jong Ho; Kim, Jin Oh; Bae, Sung Han

Abstract

Backgroued/Aims: The studies about roles of H. pylori in gastritis, gastric ulcer, duodenal ulcer and stomach cancer have been actively performed and clinically applied. Multiple tests are available for determining H. pylori infection. However, there is no ideal method for detecting H. pylori. This study was to compare the sensitivity and specificity of the most widely available tests for the diagnosis of H. pylori and to evaluate the clinical useflness of 13C-urea breath test (UBT) that was developed recently as a noninvasive diagnostic method for the detection of H. pylori infection.
METHODS
Twenty one patients (mean age 46+/-21 years, 19 male, 2 female) including 6 patients with chronic active gastritis, 6 patients with gastric ulcer and 9 patients with duodenal ulcer were tested for H. pylori infection by 13C-UBT and measurement of serum immunoglobulin G antibody levels, In addition antral biopsy specimens were obtained and used for rapid urese test, histology, culture, and polymerase chain reaction, In 13C-UBT, we measured the expiratory 13C-urea concentration of basal and 30 min value after oral ingestion of water mixed 13C-urea, using MAT instrument of Isotechnika company. No patients received specific treatment for H. pylori before testing.
RESULTS
The 13C-UBT was more sensitive and less specific than other tests for the diagnosis of H. pylori infection, but did not have statistical significance (p>0.05). The 13C-UBT had advantages, in that simple, noninvasive, short-time required. Moreover, it was no radiation expasure method unlike 14C-UBT. However, it also had disadvantages because it required high cost and need at the mass speetrometer in test reading.
CONCLUSIONS
13C-UBT is considered as one of the noninvasive methods for diagnosing H. pylori infection and evaluating the treatment efficacy after eradication of the bacteria in clinical use.