BREATH TEST FOR THE DIAGNOSIS OF HELICOBA CTER-PYLORI INFECTION - CONCORDANCE WITH HISTOLOGIC METHODS AND CORRELATION WITH HISTOLOGIC LESIONS OF THE GASTRIC-MUCOSA

Purpose: To study the concordance between C-13- urea breath test and h istology in the diagnosis of Helicobacter pylori infection, and to eva luate whether there is a correlation between breath test values and hi stologic lesions of the gastric mucosa. Methods: Sixty-nine patients w ith duodenal ulcer were prospectively studied. An endoscopy with biops y samples (H&E stain) taken from the antrum and body was performed, an d a C-13-urea breath test (measuring C-13 difference: delta(13)CO(2)) was also done. Both procedures were repeated one month after completin g therapy [<<classi>> triple therapy (n = 28), and omeprazole+a-moxyci llin (n = 41)]. Eradication was defined as the absence of H. pylori bo th by histological and breath test methods. Results: At the beginning of the study, 94.2% of patients (n = 65) were H. pylori positive by hi stological methods, and 98.6% (n = 68) were positive by the breath tes t (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 delt a(13)CO(2) and histologic lesions was observed, both in the antrum at before treatment (Spearman coef = 0.34; p = 0.007) and after therapy i n 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(13)C O(2) in patients with different degrees of histologic gastritis, both before treatment tantrum: W Kruskal-Wallis = 6; p < 0.05) and after th erapy tantrum: W = 17; p < 0.001; body: W = 10; p < 0.05). Conclusion: A high concordance was observed between the C-13-urea breath test and histology in the diagnosis of H. pylori infection. A correlation exis ts between breath test Values and histologic lesions of the gastric mu cosa.