Background: Different tests are available for diagnosing Helicobacter pylor
Aim: To compare the most commonly used tests either alone or in combination
in Chinese patients with respect to routine clinical use or research purpo
Methods: A total of 294 consecutive dyspeptic patients without previous H.
pylori treatment were recruited. During upper endoscopy, biopsies were take
n from the antrum and corpus, for a commercially available CLO-test, an in-
house rapid urease test, culture, polymerase chain reaction and histologica
l examination. Patients then received a C-13-urea breath test. The H. pylor
i status of each patient was determined by a concordance of test results.
Results: For routine clinical use, histology (antral plus corpus biopsies)
had an accuracy of 100%,, whilst the rapid urease test had an accuracy of 9
9.7%. The C-13-urea breath test was equally reliable, with an accuracy of 9
4.5%. Combinations of two tests did not confer additional advantage over th
e most accurate single test. For research purposes, the accuracy of using t
he criteria of two positives out of three diagnostic tests was 100%, and eq
uivocal results were not found.
Conclusion: Histology with or without a rapid urease test was highly accura
te for routine clinical use. Alternatively, the C-13-urea breath test was a
n equally reliable non-invasive test. The two positives out of three tests
approach was highly reliable in predicting H. pylori status of untreated Ch
inese patients in a research setting.