Academic Journal
Diagnostic Performance of 6 Tests for Helicobacterpylori Infection in Peptic Ulcer Bleeding: A Prospective Head-to-Head Comparison.
| Τίτλος: | Diagnostic Performance of 6 Tests for Helicobacterpylori Infection in Peptic Ulcer Bleeding: A Prospective Head-to-Head Comparison. |
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| Συγγραφείς: | Geeratragool T; Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Atthakitmongkol T; Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Tansirichaiya S; Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand ., Weeranawin P; Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Leelakusolvong S; Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Maneerattanaporn M; Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. |
| Πηγή: | Clinical and translational gastroenterology [Clin Transl Gastroenterol] 2026 Oct 01; Vol. 17 (10), pp. e01087. Date of Electronic Publication: 2026 Aug 27. |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101532142 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2155-384X (Electronic) Linking ISSN: 2155384X NLM ISO Abbreviation: Clin Transl Gastroenterol Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2019-> : [Philadelphia, PA] : Wolters Kluwer Health Original Publication: New York, NY : Nature Pub. Group |
| Ιατρικοί όροι (MeSH): | Helicobacter Infections*/diagnosis , Helicobacter Infections*/microbiology , Helicobacter Infections*/complications , Helicobacter Infections*/blood , Helicobacter pylori*/isolation & purification , Helicobacter pylori*/immunology , Helicobacter pylori*/genetics , Peptic Ulcer Hemorrhage*/microbiology , Peptic Ulcer Hemorrhage*/diagnosis , Peptic Ulcer Hemorrhage*/etiology, Breath Tests/methods ; Urease/analysis ; Urease/immunology ; Urea/analysis ; Humans ; Female ; Prospective Studies ; Male ; Polymerase Chain Reaction ; Middle Aged ; Biopsy ; Sensitivity and Specificity ; Aged ; False Negative Reactions ; Adult |
| Περίληψη: | Introduction: Rapid urease test (RUT) is widely used for diagnosing Helicobacter pylori (HP) because it is inexpensive and practical. However, its accuracy is reduced in peptic ulcer bleeding (PUB). We prospectively performed a head-to-head comparison of diagnostic tests in the same patients to evaluate their performance in this setting. Methods: After endoscopic hemostasis, gastric biopsies were obtained for RUT, histology, and polymerase chain reaction (PCR). Blood samples were collected for current infection marker and antiurease antibody. Urea breath testing (UBT) was performed in patients with negative RUT and histology. Diagnostic performance was assessed using a composite reference standard defined by at least 2 positive results among RUT, histology, PCR, and UBT. Logistic regression was used to identify factors associated with false-negative RUT. Results: A total of 135 patients with PUB were enrolled, of whom 36 (26.7%) were HP-positive. Sensitivity/specificity was 69.4%/97.0% for RUT, 55.6%/96.0% for histology, 97.2%/92.9% for PCR, 77.8%/77.8% for current infection marker, and 83.3%/62.6% for antiurease antibody. Combining RUT, histology, and either PCR or UBT increased sensitivity to 100% and significantly outperformed RUT alone ( P = 0.021 and P = 0.001, respectively). PCR reduced idiopathic ulcers from 31.9% to 26.7%. Only 43 of 98 patients with negative RUT and histology underwent UBT because of clinical constraints, limiting its practicality despite excellent performance. No predictors of false-negative RUT were identified. Discussion: In PUB, tissue PCR showed the best overall diagnostic performance among the single tests. RUT alone is insufficient for diagnosing HP, whereas combined testing with RUT, histology, and PCR or UBT achieved the highest diagnostic performance. (Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of The American College of Gastroenterology.) |
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| Grant Information: | Thai Healthy Gut Fund, Siriraj Foundation, Faculty of Medicine Siriraj Hospital, Mahidol University. |
| Contributed Indexing: | Keywords: diagnostic performance; histology; peptic ulcer bleeding; rapid urease test; tissue PCR; urea breath test |
| Molecular Sequence: | ClinicalTrials.gov NCT06273384 |
| Substance Nomenclature: | EC 3.5.1.5 (Urease) 8W8T17847W (Urea) |
| Entry Date(s): | Date Created: 20260827 Date Completed: 20261027 Latest Revision: 20261027 |
| Update Code: | 20261028 |
| PubMed Central ID: | PMC13694075 |
| DOI: | 10.14309/ctg.0000000000001087 |
| PMID: | 42658179 |
| Βάση Δεδομένων: | MEDLINE |
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