Diagnostic tests for Helicobacter pylori : A prospective evaluation of their accuracy, without selecting a single test as the gold standard

摘要: OBJECTIVE: To assess the accuracy of six commonly used diagnostic tests for Helicobacter pylori in a prospective study without using any specific test as gold standard (the patient was regarded H. pylori-infected if two or more tests, whatever their nature, were positive). METHODS: In 105 outpatients undergoing upper GI endoscopy, 62 significant abnormalities, 28 with gastroesophageal reflux disease, 19 peptic ulcer, one erosive gastritis, and atrophic gastritis (some patients had than diagnosis), antral biopsy specimens taken culture, polymerase chain reaction, histological examination (hematoxylineosin Giemsa stains), rapid urease test. Corpus examination. Serology (ELISA) 13C-urea breath also performed. Consistency diagnosis between pathologists assessed by kappa statistics. RESULTS: Sensitivity specificity, respectively, follows: 98.4 100%; 96.7 (antrum), 96 98.8%; (antrum + corpus), test, 90.2 100 serological examination, 88.4% (95% those who not been previously treated pylori). All pylori-positive cases detected culture 86.4% these all biopsy-based positive. Agreement good, coefficient around 0.90 specimens. CONCLUSIONS: well are accurate infection. Sampling error is problem minor importance. The lower specificity may be largely explained previous treatment pylori.