AIM： To validate an optimized ^13C-urea breath test （^13C-UBT） protocol for the diagnosis of H pylori infection that is cost-efficient and maintains excellent diagnostic accuracy. METHODS： 70 healthy volunteers we...AIM： To validate an optimized ^13C-urea breath test （^13C-UBT） protocol for the diagnosis of H pylori infection that is cost-efficient and maintains excellent diagnostic accuracy. METHODS： 70 healthy volunteers were tested with two simplified ^13C-UBT protocols, with test meal （Protocol 2） and without test meal （Protocol 1）. Breath samples were collected at 10, 20 and 30 rain after ingestion of 50 mg ^13C-urea dissolved in 10 mL of water, taken as a single swallow, followed by 200 mL of water （pH 6.0） and a circular motion around the waistline to homogenize the urea solution. Performance of both protocols was analyzed at various cut-off values. Results were validated against the European protocol. RESULTS： According to the reference protocol, 65.7% individuals were positive for H pylori infection and 34.3% were negative. There were no significant differences in the ability of both protocols to correctly identify positive and negative H pylori individuals. However, only Protocol 1 with no test meal achieved accuracy, sensitivity, specificity, positive and negative predictive values of 100%. The highest values achieved by Protocol 2 were 98.57%, 97.83%, 100%, 100% and 100%, respectively.CONCLUSION： A 10 min, 50 mg ^13C-UBT with no test meal using a cut-off value of 2-2.5 is a highly accurate test for the diagnosis of H pylori infection at a reduced cost.展开更多
AIM: To compare the accuracy of capsule 13C-urea breath test (UBT) with conventional invasive methods for the diagnosis of Helicobacter pylori infection.METHODS: One hundred patients received CLO test,histological exa...AIM: To compare the accuracy of capsule 13C-urea breath test (UBT) with conventional invasive methods for the diagnosis of Helicobacter pylori infection.METHODS: One hundred patients received CLO test,histological examination, culture and 100- or 50-mg capsule UBT for the diagnosis of Hpyloriinfection. Hpylori infection was defined as those with positive culture or positive results from both histology and CLO test.RESULTS: Both the sensitivity and specificity of the 100-mg capsule UBT (n = 50) were 100%. The sensitivity and specificity of the 50-mg capsule UBT (n = 50) were 96.4and 100%, respectively. Taken together, the accuracy of capsule UBT (n=100) was higher than that of CLO test,histology and culture (100% vs 92%, 91% and 89%,respectively; P= 0.035, 0.018 and 0.005, respectively). Our data showed that the optimal timing of sampling for 100-and 50-mg capsule UBT was 15-30 and 6-15 min, respectively.CONCLUSION: Capsule UBT has a higher accuracy compared with biopsy-based tests. It is an ideal method for the diagnosis of Hpyloriinfection.展开更多
AIM:To compare the costs and effectiveness of no screening and no eradication therapy, the population- based Helicobacter pylori (H pylori) serology screening with eradication therapy and 13C-Urea breath test (UBT) wi...AIM:To compare the costs and effectiveness of no screening and no eradication therapy, the population- based Helicobacter pylori (H pylori) serology screening with eradication therapy and 13C-Urea breath test (UBT) with eradication therapy. METHODS:A Markov model simulation was carried out in all 237 900 Chinese males with age between 35 and 44 from the perspective of the public healthcare provider in Singapore. The main outcome measures were the costs, number of gastric cancer cases prevented, life years saved, and quality-adjusted life years (QALYs) gained from screening age to death. The uncertainty surrounding the cost-effectiveness ratio was addressed by one-way sensitivity analyses. RESULTS:Compared to no screening, the incremental cost-effectiveness ratio (ICER) was $16 166 per life year saved or $13 571 per QALY gained for the serology screening, and $38 792 per life year saved and $32 525 per QALY gained for the UBT. The ICER was $477 079 per life year saved or $390 337 per QALY gained for the UBT compared to the serology screening. The cost- effectiveness of serology screening over the UBT was robust to most parameters in the model. CONCLUSION:The population-based serologyscreening for H pylori was more cost-effective than the UBT in prevention of gastric cancer in Singapore Chinese males.展开更多
AIM: To investigate whether posture affects the accuracy of 13C-urea breath test(13C-UBT) for Helicobacter pylori(H. pylori) detection in partial gastrectomy patients. METHODS: We studied 156 consecutive residual stom...AIM: To investigate whether posture affects the accuracy of 13C-urea breath test(13C-UBT) for Helicobacter pylori(H. pylori) detection in partial gastrectomy patients. METHODS: We studied 156 consecutive residual stomach patients, including 76 with H. pylori infection(infection group) and 80 without H. pylori infection(control group). H. pylori infection was confirmed if both the rapid urease test and histology were positive during gastroscopy. The two groups were divided into four subgroups according to patients' posture during the 13C-UBT: subgroup A, sitting position; subgroup B, supine position; subgroup C, right lateral recumbent position; and subgroup D, left lateral recumbent position. Each subject underwent the following modified 13C-UBT: 75 mg of 13C-urea(powder) in 100 m L of citric acid solution was administered, and a mouth wash was performed immediately; breath samples were then collected at baseline and at 5-min intervals up to 30 min while the position was maintained. Seven breathsamples were collected for each subject. The cutoff value was 2.0‰.RESULTS: The mean delta over baseline(DOB) values in the subgroups of the infection group were similar at 5 min(P > 0.05) and significantly higher than those in the corresponding control subgroups at all time points(P < 0.01). In the infection group, the mean DOB values in subgroup A were higher than those in other subgroups within 10 min and peaked at the 10-min point(12.4‰± 2.4‰). The values in subgroups B and C both reached their peaks at 15 min(B, 13.9‰± 1.5‰; C, 12.2‰± 1.7‰) and then decreased gradually until the 30-min point. In subgroup D, the value peaked at 20 min(14.7‰± 1.7‰). Significant differences were found between the values in subgroups D and B at both 25 min(t = 2.093, P = 0.043) and 30 min(t = 2.141, P = 0.039). At 30 min, the value in subgroup D was also significantly different from those in subgroups A and C(D vs C: t = 6.325, P = 0.000; D vs A: t = 5.912, P = 0.000). The mean DOB values of subjects with Billroth Ⅰ anastomosis were higher than those of subjects with Billroth Ⅱ anastomosis irrespectively of the detection time and posture(P > 0.05).CONCLUSION: Utilization of the left lateral recumbent position during the procedure and when collecting the last breath sample may improve the diagnostic accuracy of the 13C-UBT in partial gastrectomy patients.展开更多
A capsulated microdose 14C-urea breath test (14C-UBT) was developed to detect Helicobacter pylori (HP) infection in 137 patients (54 HP negative and 83 HP positive individuals)to whom a single dose of 3. 7ｘ 104 Bq of...A capsulated microdose 14C-urea breath test (14C-UBT) was developed to detect Helicobacter pylori (HP) infection in 137 patients (54 HP negative and 83 HP positive individuals)to whom a single dose of 3. 7ｘ 104 Bq of 14C-urea in a capsule was given. Samples of exhaled gas were collected at the sib, 10th, 15th. 20th, 25th, 30th, 45th and 60th minute after the administration and the peak value of exhaled 14CO2 was found in the samples collected at the 25th minute. This peak value was taken as the measuring point and directly expressed as Bq/mmol CO2 to develop a new detecting method. Then its results were compared with those of HP culture and histological examination. It was found that the samples collected on the 25th minute showed a sensitivity of 97. 06%, specificity of 95. 12%, positive predictive value of 97. 06% and negative predictive value of 95. 12% respectively when the mean value of 14CO2 in HP negative subjects ±3s on the 25th minute was taken as the critical value. This suggests that the capsule-based microdose 14C-UBT may replace conventional 14C-UBT using a larger dose of (1. 85-3. 7)ｘ 105 Bq for it is non-invasive, safe, rapid, accurate, simple and economic.展开更多
The aim of this study is to evaluate the diagnostic value of ^14C-UBT for diagnosis of HP infection. The positive predictive values were above 100 bpm/mmol CO2. 202 of 256 patients with HP-positive infection were dete...The aim of this study is to evaluate the diagnostic value of ^14C-UBT for diagnosis of HP infection. The positive predictive values were above 100 bpm/mmol CO2. 202 of 256 patients with HP-positive infection were detected (sensitivity, 78%), what's more, breath test and RUT corresponded well. 256 patients diagnosed were investigated, aged 17-81 years (average 44.25 years). HP positive rate was 96.5% in 113 patients with peptic ulcer disease (PUD), 91.7% in 60 patients with chronic active gastritis, 73.3% in 15 patients with GERD,展开更多
Objective:Magnetically controlled capsule gastroscopy(MCCG)is an effective method for screening gastric diseases;however,its performance may be affected by gastric cleanliness.We aimed to explore the correlation betwe...Objective:Magnetically controlled capsule gastroscopy(MCCG)is an effective method for screening gastric diseases;however,its performance may be affected by gastric cleanliness.We aimed to explore the correlation between Helicobacter pylori infection and the degree of gastric cleanliness in the MCCG.Methods:This retrospective study enrolled 297 participants from October 2020 to April 2024 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Participant characteristics,MCCG examination results,and(13)C-urea breath test(C13-UBT)results were collected.The gastric cleanliness in MCCG examinations was assessed using a gastric cleanliness score.Binary logistic regression was used to analyze the relationships among participant characteristics,H.pylori infection,and gastric cleanliness.Chi-square tests and Fisher's exact tests were used to analyze the relationships among gastric lesions,H.pylori infection,and gastric cleanliness.Results:Among the participants,24.2%had H.pylori infection,and 17.5%had poor gastric cleanliness.Hypertension(odds ratio[OR]:2.63;95%confidence interval[CI]:1.36e5.09;p?0.004)was associated with a greater likelihood of H.pylori infection.H.pylori infection(OR:3.76;95%CI:1.99e7.09;p<0.001)was an independent risk factor for poor gastric cleanliness in the MCCG.A significant disparity was noted in the prevalence of focal erosions(p<0.001),gastric ulcers(p?0.001),and positive gastric lesions(p?0.027)between the 2 groups with and without H.pylori infection.The proportion of positive gastric lesions was not significantly different between the good gastric cleanliness group and the poor gastric cleanliness group(25.7%vs.21.2%;p?0.490).Conclusion:The findings of this study revealed that H.pylori infection was associated with hypertension.H.pylori infection may lead to poor gastric cleanliness.Institutions are advised to perform C13-UBT before MCCG,and participants should be informed of the risk of poor gastric cleanliness if the results are positive.The decision to perform H.pylori eradication before MCCG should take into account patient willingness and the benefit-to-risk ratio.展开更多
文摘AIM： To validate an optimized ^13C-urea breath test （^13C-UBT） protocol for the diagnosis of H pylori infection that is cost-efficient and maintains excellent diagnostic accuracy. METHODS： 70 healthy volunteers were tested with two simplified ^13C-UBT protocols, with test meal （Protocol 2） and without test meal （Protocol 1）. Breath samples were collected at 10, 20 and 30 rain after ingestion of 50 mg ^13C-urea dissolved in 10 mL of water, taken as a single swallow, followed by 200 mL of water （pH 6.0） and a circular motion around the waistline to homogenize the urea solution. Performance of both protocols was analyzed at various cut-off values. Results were validated against the European protocol. RESULTS： According to the reference protocol, 65.7% individuals were positive for H pylori infection and 34.3% were negative. There were no significant differences in the ability of both protocols to correctly identify positive and negative H pylori individuals. However, only Protocol 1 with no test meal achieved accuracy, sensitivity, specificity, positive and negative predictive values of 100%. The highest values achieved by Protocol 2 were 98.57%, 97.83%, 100%, 100% and 100%, respectively.CONCLUSION： A 10 min, 50 mg ^13C-UBT with no test meal using a cut-off value of 2-2.5 is a highly accurate test for the diagnosis of H pylori infection at a reduced cost.
基金Supported by Grant From the National Science Council, Taiwan NSC 90-2314-B-075B-008
文摘AIM: To compare the accuracy of capsule 13C-urea breath test (UBT) with conventional invasive methods for the diagnosis of Helicobacter pylori infection.METHODS: One hundred patients received CLO test,histological examination, culture and 100- or 50-mg capsule UBT for the diagnosis of Hpyloriinfection. Hpylori infection was defined as those with positive culture or positive results from both histology and CLO test.RESULTS: Both the sensitivity and specificity of the 100-mg capsule UBT (n = 50) were 100%. The sensitivity and specificity of the 50-mg capsule UBT (n = 50) were 96.4and 100%, respectively. Taken together, the accuracy of capsule UBT (n=100) was higher than that of CLO test,histology and culture (100% vs 92%, 91% and 89%,respectively; P= 0.035, 0.018 and 0.005, respectively). Our data showed that the optimal timing of sampling for 100-and 50-mg capsule UBT was 15-30 and 6-15 min, respectively.CONCLUSION: Capsule UBT has a higher accuracy compared with biopsy-based tests. It is an ideal method for the diagnosis of Hpyloriinfection.
文摘AIM:To compare the costs and effectiveness of no screening and no eradication therapy, the population- based Helicobacter pylori (H pylori) serology screening with eradication therapy and 13C-Urea breath test (UBT) with eradication therapy. METHODS:A Markov model simulation was carried out in all 237 900 Chinese males with age between 35 and 44 from the perspective of the public healthcare provider in Singapore. The main outcome measures were the costs, number of gastric cancer cases prevented, life years saved, and quality-adjusted life years (QALYs) gained from screening age to death. The uncertainty surrounding the cost-effectiveness ratio was addressed by one-way sensitivity analyses. RESULTS:Compared to no screening, the incremental cost-effectiveness ratio (ICER) was $16 166 per life year saved or $13 571 per QALY gained for the serology screening, and $38 792 per life year saved and $32 525 per QALY gained for the UBT. The ICER was $477 079 per life year saved or $390 337 per QALY gained for the UBT compared to the serology screening. The cost- effectiveness of serology screening over the UBT was robust to most parameters in the model. CONCLUSION:The population-based serologyscreening for H pylori was more cost-effective than the UBT in prevention of gastric cancer in Singapore Chinese males.
基金Supported by The Guidance Project of Science and Technology Commission of Shanghai MunicipalityNo.134119a1700+5 种基金the Appropriate Project of Shanghai Municipal Health BureauNo.2013SY049Shanghai Key Laboratory of Clinical Geriatric MedicineNo.13DZ2260700the Scientific Research Projects of Shanghai Municipal Health BureauNo.20134377
文摘AIM: To investigate whether posture affects the accuracy of 13C-urea breath test(13C-UBT) for Helicobacter pylori(H. pylori) detection in partial gastrectomy patients. METHODS: We studied 156 consecutive residual stomach patients, including 76 with H. pylori infection(infection group) and 80 without H. pylori infection(control group). H. pylori infection was confirmed if both the rapid urease test and histology were positive during gastroscopy. The two groups were divided into four subgroups according to patients' posture during the 13C-UBT: subgroup A, sitting position; subgroup B, supine position; subgroup C, right lateral recumbent position; and subgroup D, left lateral recumbent position. Each subject underwent the following modified 13C-UBT: 75 mg of 13C-urea(powder) in 100 m L of citric acid solution was administered, and a mouth wash was performed immediately; breath samples were then collected at baseline and at 5-min intervals up to 30 min while the position was maintained. Seven breathsamples were collected for each subject. The cutoff value was 2.0‰.RESULTS: The mean delta over baseline(DOB) values in the subgroups of the infection group were similar at 5 min(P > 0.05) and significantly higher than those in the corresponding control subgroups at all time points(P < 0.01). In the infection group, the mean DOB values in subgroup A were higher than those in other subgroups within 10 min and peaked at the 10-min point(12.4‰± 2.4‰). The values in subgroups B and C both reached their peaks at 15 min(B, 13.9‰± 1.5‰; C, 12.2‰± 1.7‰) and then decreased gradually until the 30-min point. In subgroup D, the value peaked at 20 min(14.7‰± 1.7‰). Significant differences were found between the values in subgroups D and B at both 25 min(t = 2.093, P = 0.043) and 30 min(t = 2.141, P = 0.039). At 30 min, the value in subgroup D was also significantly different from those in subgroups A and C(D vs C: t = 6.325, P = 0.000; D vs A: t = 5.912, P = 0.000). The mean DOB values of subjects with Billroth Ⅰ anastomosis were higher than those of subjects with Billroth Ⅱ anastomosis irrespectively of the detection time and posture(P > 0.05).CONCLUSION: Utilization of the left lateral recumbent position during the procedure and when collecting the last breath sample may improve the diagnostic accuracy of the 13C-UBT in partial gastrectomy patients.
文摘A capsulated microdose 14C-urea breath test (14C-UBT) was developed to detect Helicobacter pylori (HP) infection in 137 patients (54 HP negative and 83 HP positive individuals)to whom a single dose of 3. 7ｘ 104 Bq of 14C-urea in a capsule was given. Samples of exhaled gas were collected at the sib, 10th, 15th. 20th, 25th, 30th, 45th and 60th minute after the administration and the peak value of exhaled 14CO2 was found in the samples collected at the 25th minute. This peak value was taken as the measuring point and directly expressed as Bq/mmol CO2 to develop a new detecting method. Then its results were compared with those of HP culture and histological examination. It was found that the samples collected on the 25th minute showed a sensitivity of 97. 06%, specificity of 95. 12%, positive predictive value of 97. 06% and negative predictive value of 95. 12% respectively when the mean value of 14CO2 in HP negative subjects ±3s on the 25th minute was taken as the critical value. This suggests that the capsule-based microdose 14C-UBT may replace conventional 14C-UBT using a larger dose of (1. 85-3. 7)ｘ 105 Bq for it is non-invasive, safe, rapid, accurate, simple and economic.
文摘The aim of this study is to evaluate the diagnostic value of ^14C-UBT for diagnosis of HP infection. The positive predictive values were above 100 bpm/mmol CO2. 202 of 256 patients with HP-positive infection were detected (sensitivity, 78%), what's more, breath test and RUT corresponded well. 256 patients diagnosed were investigated, aged 17-81 years (average 44.25 years). HP positive rate was 96.5% in 113 patients with peptic ulcer disease (PUD), 91.7% in 60 patients with chronic active gastritis, 73.3% in 15 patients with GERD,
基金supported by the General Research Project of the Department of Education of Zhejiang Province,China(No.Y202351338)the Soft Science Project of the Department of Science and Technology of Zhejiang Province,China(No.2024C35054).
文摘Objective:Magnetically controlled capsule gastroscopy(MCCG)is an effective method for screening gastric diseases;however,its performance may be affected by gastric cleanliness.We aimed to explore the correlation between Helicobacter pylori infection and the degree of gastric cleanliness in the MCCG.Methods:This retrospective study enrolled 297 participants from October 2020 to April 2024 at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine.Participant characteristics,MCCG examination results,and(13)C-urea breath test(C13-UBT)results were collected.The gastric cleanliness in MCCG examinations was assessed using a gastric cleanliness score.Binary logistic regression was used to analyze the relationships among participant characteristics,H.pylori infection,and gastric cleanliness.Chi-square tests and Fisher's exact tests were used to analyze the relationships among gastric lesions,H.pylori infection,and gastric cleanliness.Results:Among the participants,24.2%had H.pylori infection,and 17.5%had poor gastric cleanliness.Hypertension(odds ratio[OR]:2.63;95%confidence interval[CI]:1.36e5.09;p?0.004)was associated with a greater likelihood of H.pylori infection.H.pylori infection(OR:3.76;95%CI:1.99e7.09;p<0.001)was an independent risk factor for poor gastric cleanliness in the MCCG.A significant disparity was noted in the prevalence of focal erosions(p<0.001),gastric ulcers(p?0.001),and positive gastric lesions(p?0.027)between the 2 groups with and without H.pylori infection.The proportion of positive gastric lesions was not significantly different between the good gastric cleanliness group and the poor gastric cleanliness group(25.7%vs.21.2%;p?0.490).Conclusion:The findings of this study revealed that H.pylori infection was associated with hypertension.H.pylori infection may lead to poor gastric cleanliness.Institutions are advised to perform C13-UBT before MCCG,and participants should be informed of the risk of poor gastric cleanliness if the results are positive.The decision to perform H.pylori eradication before MCCG should take into account patient willingness and the benefit-to-risk ratio.
