AIM: To validate and compare the cost of microdose 14C urea breath test (UBT) with histology and rapid urease test for the diagnosis of H Pylori. METHODS: Ninety-four consecutive patients with dyspeptic symptoms under...AIM: To validate and compare the cost of microdose 14C urea breath test (UBT) with histology and rapid urease test for the diagnosis of H Pylori. METHODS: Ninety-four consecutive patients with dyspeptic symptoms undergoing gastroscopy were enrolled. Gastric biopsies were taken for histology and rapid urease test. UBT was performed after gastroscopy by microdose 14C urea capsules. Sensitivity, specificity and accuracy of UBT were calculated and compared with histology and rapid urease test. Cost comparison of these tests was also performed. RESULTS: H pylori was diagnosed by histology and rapid urease test in 66 (70%) and 61 (65%) patients, while 14C UBT detected infection in 63 (67%). Accuracy of UBT was 93% in comparison with histology while its positive and negative predictive values were 97% and 84%, respectively. Comparison of 14C UBT with rapid urease test gives an accuracy of 96%, with positive and negative predictive values of 95% and 97%, respectively. These results were highly reproducible with a Kappa test (P value < 0.001). Cost of histology or rapid urease test with gastroscopy was 110 USD or 95 USD respectively while the cost of UBT was 15 USD. CONCLUSION: Microdose 14C UBT was comparable to histology and rapid urease test. 14C UBT is an economical, self sufficient and suitable test to diagnose active H pylori infection in less developed countries.展开更多
BACKGROUND^(14)C urea breath test(^(14)C UBT)and immunohistochemical staining(IHC)are widely used for detection Helicobacter pylori(H.pylori)infection with different sensitivity,and there is a difference in H.pylori i...BACKGROUND^(14)C urea breath test(^(14)C UBT)and immunohistochemical staining(IHC)are widely used for detection Helicobacter pylori(H.pylori)infection with different sensitivity,and there is a difference in H.pylori infection rate in Uyghur and Han ethnic groups.Both need large cohort studies to evaluate the differences more accurately.AIM To analyze the difference between^(14)C UBT and IHC for H.pylori detection in Xinjiang Uyghur Autonomous Region and the difference between Uyghur and Han populations.METHODS There were 3944 cases of H.pylori infection detected by both IHC and^(14)C UBT at the same time(interval<1 wk,with sampling site including gastric antrum,selected from 5747 patients).We compared the sensitivity of^(14)C UBT and IHC.We also compared 555 pairs of Han/Uyghur cases(completely matched for gender and age)for their H.pylori infection rates.The overall H.pylori infection rate of all 5747 cases and the correlation with other clinicopathological data were also further analyzed.SPSS V23.0 software was used for statistical analysis.RESULTS The sensitivity was 94.9%for^(14)C UBT and 65.1%for IHC,which was a significant difference(n=3944,P<0.001).However,among those cases negative for H.pylori by^(14)C UBT(detection value≤100),4.8%were positive by IHC.Combining both methods,the overall H.pylori infection rate was 48.6%(n=5747),and differences in gender,age group,ethnicity and region of residence significantly affected the H.pylori positive rates.According to age group(Han/Uyghur),the positive rates were≤30 years(62.2%/100.0%),31-40 years(45.2%/85.7%),41-50 years(47.2%/79.2%),51-60 years(44.6%/76.1%),61-70 years(40.9%/68.2%),71-80 years(41.7%/54.1%)and≥81 years(42.9%/NA).The H.pylori infection rates of Han/Uyghur paired cases were 41.4%and 73.3%,which was a significant difference(P<0.001)(555 pairs).H.pylori positivity was significantly related to moderate-severe grade 2-3 chronic/active gastritis and intestinal metaplasia(all P<0.05).CONCLUSION The sensitivity of^(14)C UBT was significantly higher,but combined application can still increase the accuracy.The prevention H.pylori should be emphasized for Uygur and young people.展开更多
目的:了解幽门螺杆菌(Helicobacter pylori,H.p y l o r i)感染与冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CAHD)的相关性.方法:对吉林大学第四医院心内科就诊并明确诊断为CAHD的1030例病例和同期体检中心非C...目的:了解幽门螺杆菌(Helicobacter pylori,H.p y l o r i)感染与冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CAHD)的相关性.方法:对吉林大学第四医院心内科就诊并明确诊断为CAHD的1030例病例和同期体检中心非CAHD的受检者1116例行14C-尿素呼气试验检查,比较两组H.pylori阳性率.CAHD组根据H.pylori检测结果分成H.pylori阳性组和H.pylori阴性组,分析两组患者的血清同型半胱氨酸水平的差别.根据SYNTAX评分将CAHD患者分为低危组、中危组、高危组,分析各组患者H.pylori阳性率的差异,H.pylori阳性的CAHD患者进一步分析各危险组的血清同型半胱氨酸水平差异.结果:CAHD患者H.pylori的阳性率高于体检组,差异有统计学意义(P<0.01).CAHD患者中H.pylori阳性组血清同型半胱氨酸浓度高于阴性组,差异有统计学意义(P<0.01).高危组CAHD患者的H.pylori阳性率最高,其次是中危组,低危组阳性率最低,但差异无统计学意义(P>0.05).H.pylori阳性的CAHD患者随着危险度增加其血清同型半胱氨酸浓度也增加,各组间比较差异有统计学意义(P<0.01).结论:H.pylori感染很可能是CAHD的重要危险因素,H.pylori感染可能通过升高血清同型半胱氨酸水平来增加冠状动脉损害程度,从而促进冠状动脉粥样硬化的发生和发展,有待于进一步探讨.展开更多
基金University Research Council Grant, No. 041F431YC
文摘AIM: To validate and compare the cost of microdose 14C urea breath test (UBT) with histology and rapid urease test for the diagnosis of H Pylori. METHODS: Ninety-four consecutive patients with dyspeptic symptoms undergoing gastroscopy were enrolled. Gastric biopsies were taken for histology and rapid urease test. UBT was performed after gastroscopy by microdose 14C urea capsules. Sensitivity, specificity and accuracy of UBT were calculated and compared with histology and rapid urease test. Cost comparison of these tests was also performed. RESULTS: H pylori was diagnosed by histology and rapid urease test in 66 (70%) and 61 (65%) patients, while 14C UBT detected infection in 63 (67%). Accuracy of UBT was 93% in comparison with histology while its positive and negative predictive values were 97% and 84%, respectively. Comparison of 14C UBT with rapid urease test gives an accuracy of 96%, with positive and negative predictive values of 95% and 97%, respectively. These results were highly reproducible with a Kappa test (P value < 0.001). Cost of histology or rapid urease test with gastroscopy was 110 USD or 95 USD respectively while the cost of UBT was 15 USD. CONCLUSION: Microdose 14C UBT was comparable to histology and rapid urease test. 14C UBT is an economical, self sufficient and suitable test to diagnose active H pylori infection in less developed countries.
文摘BACKGROUND^(14)C urea breath test(^(14)C UBT)and immunohistochemical staining(IHC)are widely used for detection Helicobacter pylori(H.pylori)infection with different sensitivity,and there is a difference in H.pylori infection rate in Uyghur and Han ethnic groups.Both need large cohort studies to evaluate the differences more accurately.AIM To analyze the difference between^(14)C UBT and IHC for H.pylori detection in Xinjiang Uyghur Autonomous Region and the difference between Uyghur and Han populations.METHODS There were 3944 cases of H.pylori infection detected by both IHC and^(14)C UBT at the same time(interval<1 wk,with sampling site including gastric antrum,selected from 5747 patients).We compared the sensitivity of^(14)C UBT and IHC.We also compared 555 pairs of Han/Uyghur cases(completely matched for gender and age)for their H.pylori infection rates.The overall H.pylori infection rate of all 5747 cases and the correlation with other clinicopathological data were also further analyzed.SPSS V23.0 software was used for statistical analysis.RESULTS The sensitivity was 94.9%for^(14)C UBT and 65.1%for IHC,which was a significant difference(n=3944,P<0.001).However,among those cases negative for H.pylori by^(14)C UBT(detection value≤100),4.8%were positive by IHC.Combining both methods,the overall H.pylori infection rate was 48.6%(n=5747),and differences in gender,age group,ethnicity and region of residence significantly affected the H.pylori positive rates.According to age group(Han/Uyghur),the positive rates were≤30 years(62.2%/100.0%),31-40 years(45.2%/85.7%),41-50 years(47.2%/79.2%),51-60 years(44.6%/76.1%),61-70 years(40.9%/68.2%),71-80 years(41.7%/54.1%)and≥81 years(42.9%/NA).The H.pylori infection rates of Han/Uyghur paired cases were 41.4%and 73.3%,which was a significant difference(P<0.001)(555 pairs).H.pylori positivity was significantly related to moderate-severe grade 2-3 chronic/active gastritis and intestinal metaplasia(all P<0.05).CONCLUSION The sensitivity of^(14)C UBT was significantly higher,but combined application can still increase the accuracy.The prevention H.pylori should be emphasized for Uygur and young people.
文摘目的:了解幽门螺杆菌(Helicobacter pylori,H.p y l o r i)感染与冠状动脉粥样硬化性心脏病(coronary atherosclerotic heart disease,CAHD)的相关性.方法:对吉林大学第四医院心内科就诊并明确诊断为CAHD的1030例病例和同期体检中心非CAHD的受检者1116例行14C-尿素呼气试验检查,比较两组H.pylori阳性率.CAHD组根据H.pylori检测结果分成H.pylori阳性组和H.pylori阴性组,分析两组患者的血清同型半胱氨酸水平的差别.根据SYNTAX评分将CAHD患者分为低危组、中危组、高危组,分析各组患者H.pylori阳性率的差异,H.pylori阳性的CAHD患者进一步分析各危险组的血清同型半胱氨酸水平差异.结果:CAHD患者H.pylori的阳性率高于体检组,差异有统计学意义(P<0.01).CAHD患者中H.pylori阳性组血清同型半胱氨酸浓度高于阴性组,差异有统计学意义(P<0.01).高危组CAHD患者的H.pylori阳性率最高,其次是中危组,低危组阳性率最低,但差异无统计学意义(P>0.05).H.pylori阳性的CAHD患者随着危险度增加其血清同型半胱氨酸浓度也增加,各组间比较差异有统计学意义(P<0.01).结论:H.pylori感染很可能是CAHD的重要危险因素,H.pylori感染可能通过升高血清同型半胱氨酸水平来增加冠状动脉损害程度,从而促进冠状动脉粥样硬化的发生和发展,有待于进一步探讨.
