Gisbert J P, Boixeda D, Redondo C, Alvarez Baleriola I, Jiménez I, Pérez García J I, Pajares J M
Servicio de Gastroenterología, Hospital, Ramón y Cajal, Departmento de Medicina, Universidad de Alcalá de Henares, Madrid.
Rev Esp Enferm Dig. 1996 Apr;88(4):259-64.
To study the concordance between 13C-urea breath test and histology in the diagnosis of Helicobacter pylori infection, and to evaluate whether there is a correlation between breath test values and histologic lesions of the gastric mucosa.
Sixty-nine patients with duodenal ulcer were prospectively studied. An endoscopy with biopsy samples (H&E stain) taken from the antrum and body was performed, and a 13C-urea breath test (measuring 13C difference: delta 13CO2) was also done. Both procedures were repeated one month after completing therapy ["classic" triple therapy (n = 28), and omeprazole+amoxycillin (n = 41)]. Eradication was defined as the absence of H. pylori both by histological and breath test methods.
At the beginning of the study, 94.2% of patients (n = 65) were H. pylori positive by histological methods, and 98.6% (n = 68) were positive by the breath test (ratio of positive agreement = 0.96). Kappa for H. pylori diagnosis after therapy was 0.83 (95% CI: 0.69-0.96). A correlation between delta 13CO2 and histologic lesions was observed, both in the antrum at before treatment (Spearman coef = 0.34; p = 0.007) and after therapy in both the gastric antrum (0.63; p < 0.001) and body (0.35; p = 0.005). A significant difference was observed when comparing mean delta 13CO2 in patients with different degrees of histologic gastritis, both before treatment (antrum: W Kruskal-Wallis = 6; p < 0.05) and after therapy (antrum: W = 17; p < 0.001; body: W = 10; p < 0.05).
A high concordance was observed between the 13C-urea breath test and histology in the diagnosis of H. pylori infection. A correlation exists between breath test values and histologic lesions of the gastric mucosa.
研究¹³C - 尿素呼气试验与组织学检查在幽门螺杆菌感染诊断中的一致性，并评估呼气试验值与胃黏膜组织学病变之间是否存在相关性。
对69例十二指肠溃疡患者进行前瞻性研究。进行内镜检查并从胃窦和胃体取活检样本（苏木精 - 伊红染色），同时进行¹³C - 尿素呼气试验（测量¹³C差值：δ¹³CO₂）。在完成治疗后1个月重复这两种检查方法[“经典”三联疗法（n = 28）和奥美拉唑 + 阿莫西林（n = 41）]。根除定义为通过组织学和呼气试验方法均未检测到幽门螺杆菌。
在研究开始时，94.2%的患者（n = 65）组织学检查显示幽门螺杆菌阳性，98.6%（n = 68）呼气试验阳性（阳性一致性比例 = 0.96）。治疗后幽门螺杆菌诊断的Kappa值为0.83（95%可信区间：0.69 - 0.96）。观察到δ¹³CO₂与组织学病变之间存在相关性，治疗前胃窦部（Spearman系数 = 0.34；p = 0.007）以及治疗后胃窦部（0.63；p < 0.001）和胃体部（0.35；p = 0.005）均如此。在比较不同程度组织学胃炎患者治疗前（胃窦部：W Kruskal - Wallis = 6；p < 0.05）和治疗后（胃窦部：W = 17；p < 0.001；胃体部：W = 10；p < 0.05）的平均δ¹³CO₂时，观察到显著差异。
¹³C - 尿素呼气试验与组织学检查在幽门螺杆菌感染诊断中具有高度一致性。呼气试验值与胃黏膜组织学病变之间存在相关性。
