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The 13C-urea blood test is accurate for detecting Helicobacter pylori infection

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 QUESTION: How accurate is the 13C-urea blood test for detecting Helicobacter pylori infection?

Design

Blinded comparison of the 13C-urea blood test with tests based on endoscopic biopsy.

Setting

5 centres in the United States (Ann Arbor, Michigan; Syracuse, New York; Gainesville, Florida; Savannah, Georgia; and Los Angeles, California).

Patients

121 patients (mean age 49 y, 51% men) who were referred for endoscopy. Exclusion criteria included treatment for H. pylori infection in the previous year or use of antibiotics or bismuth in the previous month or proton-pump inhibitors in the previous 7 days.

Description of tests and diagnostic standards

Patients received 13C-urea, 125 mg dissolved in 75 ml of water. 30 minutes later, a 3-ml blood sample was obtained by venipuncture and analysed by gas isotope ratio mass spectrometry. The 3 diagnostic standards were histological evidence of H. pylori infection in biopsies obtained from the body and antrum of the stomach, a positive result for both histological and rapid urease …

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