Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, MY.
Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, MY.
Ann Glob Health. 2019 Jul 24;85(1):110. doi: 10.5334/aogh.2570.
Helicobacter pylori (H. pylori) infection is known to be associated with peptic ulcer and gastric cancer. Detection of H. pylori infection is a significant part of peptic ulcer and gastric cancer prevention and management. 13C-urea breath test (UBT) provides a good option for the pathogen detection due to its accuracy and safety.
This review aims to evaluate the 13C-UBT diagnostic accuracy studies conducted among Asian population and validate its use for the Asian population.
Original articles were systematically searched in PubMed, Scopus, and Google Scholar using the PICOS strategy by applying relevant keywords. Only studies published in English and conducted in Asia were included. Our search returned 276 articles. After assessment, 11 articles which answered our research question and met the criteria set for systematic review and meta-analysis were accepted. A total of 15 study protocols were extracted from the 11 accepted articles.
Majority of the studies were conducted in Hong Kong (six), followed by Taiwan (five), Japan (two), and one each in Singapore and Israel. All studies had used histology as part of its gold standard of reference. All but one study was performed on adult populations. The summary estimate for sensitivity was 97% (95% CI: 96, 98%), and specificity was 96% (95% CI: 95, 97%), with significant heterogeneity between studies. Adjusting for the dose (50 mg) and breath sample collection time (20 minutes) had improved both accuracy estimates and significantly reduced heterogeneity.
This review supports the test-and-treat strategy for H. pylori infection management. Prevalence and cost-effectiveness studies are mandatory for health authorities to adopt this strategy into national policy.
已知幽门螺杆菌（H. pylori）感染与消化性溃疡和胃癌有关。检测 H. pylori 感染是预防和管理消化性溃疡和胃癌的重要组成部分。由于其准确性和安全性，13C-尿素呼气试验（UBT）为病原体检测提供了一个很好的选择。
本综述旨在评估在亚洲人群中进行的 13C-UBT 诊断准确性研究，并验证其在亚洲人群中的应用。
通过应用相关关键词，采用 PICOS 策略，系统地在 PubMed、Scopus 和 Google Scholar 中搜索原始文章。仅纳入发表于英文并在亚洲进行的研究。我们的搜索返回了 276 篇文章。经过评估，有 11 篇回答了我们的研究问题并符合系统评价和荟萃分析标准的文章被接受。从这 11 篇接受的文章中提取了 15 份研究方案。
大多数研究在香港进行（6 项），其次是台湾（5 项）、日本（2 项），新加坡和以色列各有 1 项。所有研究均将组织学作为其金标准参考的一部分。除了一项研究外，其余所有研究均针对成年人群进行。敏感性的汇总估计值为 97%（95%CI：96，98%），特异性为 96%（95%CI：95，97%），研究间存在显著的异质性。调整剂量（50mg）和呼气样本采集时间（20 分钟）后，提高了准确性估计值，并显著降低了异质性。
本综述支持检测和治疗策略在 H. pylori 感染管理中的应用。为了使卫生当局将这一策略纳入国家政策，必须进行流行率和成本效益研究。
