Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 102 , Issue 2
Showing 1-10 articles out of 10 articles from the selected issue
Review article
Monthly report; Progress in Gastroenterology & Hepatology
Barrett's epithelium and Barrett's adenocarcinoma
Original article
  • Kengo TOKUNAGA, Kazuhiro WATANABE, Akifumi TANAKA, Hajime SUGANO, Kyot ...
    2005 Volume 102 Issue 2 Pages 176-182
    Published: 2005
    Released: June 06, 2005
    This study aimed to evaluate the effectiveness of the 13C-urea breath test (UBT) for assessment of Helicobacter pylori eradication after treatment. One hundred twenty six patients were enrolled with 85 receiving proton pomp inhibitor based triple therapy. They were underwent upper gastrointestinal endoscopy with biopsies for diagnosis and assessment of H. pylori infection using culture, histology, rapid urease test (RUT) and 13C-UBT. Assessment of eradication needs to be performed 4 weeks or more after completion of treatment. Breath samples were taken 15 minutes after the ingestion of 100 mg 13C-urea. Breath samples were analyzed on a mass spectrometer system. The gold standard for H. pylori infection was a positive culture or positive histology+positive RUT; negative for infection was defined as negative results of all three biopsy tests. Based on ROC curves, the most appropriate cut-off value for diagnosis of H. pylori infection was identified as 2.5‰, which provided 96.2% sensitivity, 100% specificity, and 96.8% accuracy as judged by the gold standard. However, when confirming the eradication of H. pylori, it was 3.5‰, which provides for 100%, 95.8%, and 96.5%, respectively. Ten patients (11.8%) had Δ13C values that were 2.5∼ 5.0‰ 4∼ 12 weeks after therapy. Eight patients were considered cured of H. pylori infection, and 2 were considered to still have H. pylori infection following 13C-UBT, serology, and H. pylori specific antigen test. The false-positive rate of 13C-UBT was 9.4% (8/85). When the grey zone of 13C-UBT was set at a level of 2.5 to 5.0‰ (2.5>: negative, 5.0≤: positive) after eradication therapy, the sensitivity and specificity of 13C-UBT was 100% and 98.4% compared to the gold standard. It was concluded that to avoid false-positive results of 13C-UBT, the grey zone of 13C-UBT needs to be set at a level of 2.5 to 5.0‰; thus improving the accuracy of test for the assessment of eradication of H. pylori infection
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Case Report
Lesson from a case