QUANTIFICATION OF HELICOBACTER-PYLORI INFECTION - SIMPLE AND RAPID C-13-UREA BREATH TEST IN TAIWAN

The C-13-urea breath test (C-13-UBT) is a noninvasive method for detec ting Helicobacter pylori. This study was performed to determine the cu toff value and evaluate the sensitivity and specificity of C-13-UBT in Taiwan. C-13-Urea (100 mg of 99% C-13-Iabeled urea) was dissolved in 50 mi sterile water for the test. The test meal for delaying gastric e mptying was 100 ml fresh milk. Patients fasted for at least 6 h. A bas eline breath sample was collected 5 min after they had the test meal. Two other samples were collected at 15 and 30 min after the patients i ngested the C-13-urea. The test was evaluated in 352 patients after ro utine upper gastrointestinal endoscopy, and the urease test, culture, and histopathology were taken as the gold standards for detecting H. p ylori. According to the receiver operating characteristic (ROC) curves ,we chose values of 2.8 and 4.2 excess delta (CO2)-C-13 per mil as the cut-off values for 15 and 30 min, respectively,post C-13-urea. The se nsitivity and specificity of C-13-UBT were 99% and 93% at 15 min. and 98% and 93% at 30 min post C-13-urea, respectively. The C-13-UBT breat h test is an efficient non-invasive method of high sensitivity and hig h specificity for detecting H. pylori infection. We suggest that the u se of fresh milk as the test meal and the detection of excess delta (C O2)-C-13 15 min after the ingestion of C-13-urea are suitable for the clinical use of C-13-UBT. This test is simple and rapid.