Vn. Kasho et al., FEASIBILITY OF ANALYZING [C-13]UREA BREATH TESTS FOR HELICOBACTER-PYLORI BY GAS CHROMATOGRAPHY-MASS SPECTROMETRY IN THE SELECTED-ION MONITORING MODE, Alimentary pharmacology & therapeutics, 10(6), 1996, pp. 985-995
Background: The [C-13]urea breath test for Helicobacter pylori is nonr
adioactive, as well as noninvasive, but few clinical laboratories have
the expensive isotope ratio mass spectrometer used for analysis. Meth
ods: To demonstrate the feasibility of analysing [C-13]urea breath tes
ts with a gas chromatograph-mass spectrometer routinely used for drug
testing, (CO2)-C-13 standards for breath tests and breath samples from
patients in a multiple-blind study were analysed. The breath samples
were also analysed by isotope ratio mass spectrometry, and the diagnos
es were compared with biopsy results. Results: The precision of the en
richment measurements by gas chromatography-mass spectrometry was 1.1
parts per thousand, and the calculated differences in enrichment betwe
en standard gases equaled the certified values. The sensitivity (94%),
specificity (94%), and percentage agreement (94%) for diagnosis of He
licobacter pylori (n = 34) were as high or higher than for analysis of
replicate breath samples by isotope ratio mass spectrometry and compa
rable to the values reported for diagnosis of the bacterium by other c
urrently accepted tests.Conclusions: The study demonstrates that a gas
chromatograph-mass spectrometer can be used to analyse [C-13]urea bre
ath tests, thus potentially lowering the cost of the test and increasi
ng the number of laboratories that can perform the test.