Comparison of 14c-Urea Breath Test With Gastric Histology for Diagnosis of Helicobacter Pylori Infection Among Patients With Peptic Ulcer Disease

Abstract

Background
 Helicobacter pylori infection is common among patients with peptic ulcer disease. The definitive means of diagnosing infection being histology requires endoscopy and sedation making it invasive and expensive. The carbon urea breath test is generally considered to be a simple, non-invasive and accurate test for the detection of Helicobacter pylori infection both before and after treatment.
 Objectives 
 Our objective was to compare histology with a less invasive and safer method, the 14C-urea breath test.
 Materials and Methods
 After approval of Ethical committee of the Iraqi Board for Medical Specialties, informed consent were taken from every patient before esophagogastroduodenoscopy. Fifty patients with peptic ulcer disease diagnosed by endoscopy were evaluated by 14C-urea breath test. Four biopsies were taken for histology. After endoscopy, each patient was evaluated by both tests for diagnosis of Helicobacter pylori infection
 Results
 50 patients with peptic ulcer disease Helicobacter pylori infection was diagnosed in 35 patients (63.45%), while in 15 patients (36.55%) were negative for Helicobacter pylori infection using gastric histology and urea breath test. Compared with histology, the diagnostic values of the 14C-urea breath test were: sensitivity 94%, specificity 87%, positive predictive value 94%, and negative predictive value 87%. 
 Conclusion
 The 14C-urea breath test is a noninvasive diagnostic tool for Helicobacter pylori infection. It’s a sensitive and specific test with excellent positive predictive value and its good negative predictive value guarantee its usefulness in clinical practice.