Increasing Biopsy Number and Sampling from Gastric Body Improve the Sensitivity of Rapid Urease Test in Patients with Peptic Ulcer Bleeding
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Previous studies demonstrated that the sensitivity of rapid urease test (RUT) for diagnosis of Helicobacter pylori infection decreased during peptic ulcer bleeding.
We designed this study and tried to find a better method to improve the detection rate of H. pylori infection at the same session of endoscopic diagnosis of peptic ulcer bleeding.
We prospectively enrolled 116 patients with peptic ulcer bleeding. These patients received intravenous proton pump inhibitor and then received upper gastrointestinal endoscopy within 24 h after arrival. We took one piece of biopsy from gastric antrum (Group 1), four pieces from gastric antrum (Group 2), and one piece from the gastric body (Group 3) for three separate RUTs, respectively. 13C-urease breath test was used as gold standard for diagnosis of H. pylori infection.
There were 74 patients (64 %) with positive 13C-urease breath test. Among these 74 patients, 45 patients had positive RUT (sensitivity: 61 %) in Group 1; 55 patients had positive RUT (sensitivity: 74 %) in Group 2; 54 patients had positive RUT (sensitivity: 73 %) in Group 3. There were significant differences between Group 1 and Group 2 (p = 0.02) and between Group 1 and Group 3 (p = 0.022).
The sensitivity of RUT was 61 % during peptic ulcer bleeding. The sensitivity of RUT can be increased significantly by increased biopsy number from gastric antrum or biopsy from gastric body.
KeywordsRapid urease test Helicobacter pylori Bleeding peptic ulcer Urea breath test
This work is supported by research Grants FEMH-99-C-029 from the Far Eastern Memorial Hospital.
Conflict of interest
There is no other conflict of interest needed to be disclosed.
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