van de Wouw B A, de Boer W A, Hermsen H W, Valkenburg J G, Geuskens L M, Tytgat G N
Dept. of Internal Medicine, Sint Anna Hospital, Oss, The Netherlands.
Scand J Gastroenterol. 1997 Feb;32(2):112-7. doi: 10.3109/00365529709000180.
We evaluated the reliability and usefulness of the 14C urea breath test (UBT) in confirming eradication of Helicobacter pylori 4 to 6 weeks after cessation of antimicrobial therapy.
We investigated 57 patients, who underwent both an upper endoscopy with multiple biopsy specimens taken for histopathology, culture and/or CLO test, and a 14C UBT. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the breath test were calculated against the combined biopsy-based test results. Values for sensitivity, specificity, PPV, and NPV were also calculated after excluding results in a grey zone containing equivocal test results.
Sensitivity, specificity, PPV, and NPV of the 14C UBT were 92%, 78%, 52%, and 97%, respectively. After introduction of a grey zone concept, these values were 89%, 100%, 100%, and 97% respectively.
We conclude that for research, upper gastrointestinal endoscopy with multiple biopsy specimens and using different diagnostic techniques should remain the 'gold standard' to test for cure.
我们评估了14C尿素呼气试验（UBT）在抗菌治疗停止4至6周后确认幽门螺杆菌根除情况时的可靠性和实用性。
我们调查了57例患者，这些患者既接受了上消化道内镜检查并采集多个活检标本用于组织病理学、培养和/或CLO试验，也接受了14C UBT。根据基于活检的联合试验结果计算呼气试验的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。在排除包含可疑试验结果的灰色区域的结果后，也计算了敏感性、特异性、PPV和NPV的值。
14C UBT的敏感性、特异性、PPV和NPV分别为92%、78%、52%和97%。引入灰色区域概念后，这些值分别为89%、100%、100%和97%。
我们得出结论，对于研究而言，采用多种活检标本并使用不同诊断技术的上消化道内镜检查仍应作为检测治愈情况的“金标准”。
