BACKGROUND AND AIMS: To assess the validity of biopsy-based tests (histology, culture, and urease test) and serology in detecting current H. pylori infection for the peptic ulcer patients who had gastric bleeding. METHODS: A total of 398 peptic ulcer patients were enrolled and divided into two groups, according to the presence or absence of bleeding. The diagnosis for current H. pylori infection was verified using the gold standard combining individual H. pylori tests. Sensitivity, specificity, and positive and negative predictive values of the culture, Campylobacter-like organism (CLO) test (urease test), histology, and serology were compared. RESULTS: Of the total study population (N = 398), 157 (39.4%) patients were categorized into the bleeding group. The sensitivities of the culture (40.0%) and CLO (85.0%) in the bleeding group were significantly lower than culture (58.1%) and CLO (96.4%) in the nonbleeding group (p = .012 and p < .001, respectively). In the bleeding group, the sensitivity of CLO (85.0%) was significantly lower than histology (92.5%) and serology (97.4%) (p = .013 and p = .002, respectively), which was not found in the nonbleeding group. The specificity of serology in the bleeding group (56.3%) was significantly lower than that of nonbleeding group (74.2%) (p = .038). Similarly, the specificity of serology was significantly lower than the other H. pylori tests in the bleeders. CONCLUSIONS: Bleeding decreased the sensitivity of H. pylori tests in patients with peptic ulcer, especially in urease test or culture. In contrast, histology was found to be a quite reliable test, regardless of the presence of bleeding.
BACKGROUND AND AIMS: To assess the validity of biopsy-based tests (histology, culture, and urease test) and serology in detecting current H. pyloriinfection for the peptic ulcerpatients who had gastric bleeding. METHODS: A total of 398 peptic ulcerpatients were enrolled and divided into two groups, according to the presence or absence of bleeding. The diagnosis for current H. pyloriinfection was verified using the gold standard combining individual H. pylori tests. Sensitivity, specificity, and positive and negative predictive values of the culture, Campylobacter-like organism (CLO) test (urease test), histology, and serology were compared. RESULTS: Of the total study population (N = 398), 157 (39.4%) patients were categorized into the bleeding group. The sensitivities of the culture (40.0%) and CLO (85.0%) in the bleeding group were significantly lower than culture (58.1%) and CLO (96.4%) in the nonbleeding group (p = .012 and p < .001, respectively). In the bleeding group, the sensitivity of CLO (85.0%) was significantly lower than histology (92.5%) and serology (97.4%) (p = .013 and p = .002, respectively), which was not found in the nonbleeding group. The specificity of serology in the bleeding group (56.3%) was significantly lower than that of nonbleeding group (74.2%) (p = .038). Similarly, the specificity of serology was significantly lower than the other H. pylori tests in the bleeders. CONCLUSIONS: Bleeding decreased the sensitivity of H. pylori tests in patients with peptic ulcer, especially in urease test or culture. In contrast, histology was found to be a quite reliable test, regardless of the presence of bleeding.
Authors: Adil M Allahverdiyev; Melahat Bagirova; Reyhan Caliskan; Hrisi Bahar Tokman; Hayat Aliyeva; Gokce Unal; Olga Nehir Oztel; Emrah Sefik Abamor; Hilal Toptas; Pelin Yuksel; Fatma Kalayci; Mustafa Aslan; Yusuf Erzin; Kadir Bal; Bekir S Kocazeybek Journal: World J Gastroenterol Date: 2015-03-07 Impact factor: 5.742
Authors: Hyuk Yoon; Dong Ho Lee; Eun Sun Jang; Jaihwan Kim; Cheol Min Shin; Young Soo Park; Jin-Hyeok Hwang; Jin-Wook Kim; Sook-Hayng Jeong; Nayoung Kim Journal: World J Gastroenterol Date: 2015-02-28 Impact factor: 5.742