PMID- 34174054
OWN - NLM
STAT- MEDLINE
DCOM- 20220114
LR  - 20220114
IS  - 1842-1121 (Electronic)
IS  - 1841-8724 (Linking)
VI  - 30
IP  - 2
DP  - 2021 Jun 18
TI  - The Validity of the Invasive Tests for Helicobacter Pylori Diagnosis is Unequally 
      Affected by the Consumption of Antibiotics or Pump Inhibitors. Test Performance 
      under Real-World Conditions.
PG  - 198-204
LID - 10.15403/jgld-3161 [doi]
AB  - BACKGROUND AND AIMS: Patients undergoing upper endoscopy have often used proton 
      pump inhibitors (PPI) and/or antibiotics (ABx) recently. Both drugs have been 
      associated with a poorer yield of the Helicobacter pylori (H. pylori) diagnostic 
      tests. The aim was to assess the accuracy of the polymerase chain reaction test 
      (qPCR), histological exam (HE) and ultra-fast urease test (UFUT) for H. pylori 
      detection in patients that recently used PPI or ABx. METHODS: Prospective study 
      recruiting 206 patients who underwent upper endoscopy and gastric biopsies. 
      Demographics and use of PPI/ABx were obtained. Sensibility (Sn), specificity 
      (Sp), predictive value (PV), likelihood ratio (LR) and PABAK concordance index, 
      were calculated, considering as the gold standard the positivity of 2 out of 3 
      analyzed tests. A global analysis and another one based on the PPI/ABx intake 
      were performed. RESULTS: 48.5% of patients used PPI and 12.8% ABx within the 2 
      and 4 weeks prior to endoscopy, respectively. The UFUT was positive in 13.1% of 
      patients, HE in 34% and qPCR in 35.9%. UFUT achieved lower Sn (37%) than HE (98%) 
      and qPCR (98%) (p<0.001) overall. ABx were associated with lower Sn in HE 
      (p=0.04) and lower Sp in qPCR (p=0.03). PPI did not associate with a significant 
      drop in Sn and Sp. The concordance between HE and qPCR was 0.83 (95%CI: 
      0.73-0.89). CONCLUSIONS: Under real world conditions, the accuracy and 
      concordance of HE and qPCR to diagnose H. pylori were excellent, but UFUT 
      achieved unsatisfactory outcomes. The intake of ABx was associated with the worse 
      performance, fundamentally for HE. The PPI did not reduce the tests' yield 
      significantly.
FAU - Alcedo, Javier
AU  - Alcedo J
AD  - Department of Digestive Diseases. Miguel Servet University Hospital. Zaragoza; 
      Aragon Health Research Institute (IIS Aragon), Spain. jalcedo@telefonica.net.
FAU - Casas, Diego
AU  - Casas D
AD  - Department of Digestive Diseases. Miguel Servet University Hospital. Zaragoza; 
      Aragon Health Research Institute (IIS Aragon), Spain. diegocasas8@gmail.com.
FAU - Gotor, Jesus
AU  - Gotor J
AD  - Department of Digestive Diseases. Miguel Servet University Hospital. Zaragoza; 
      Aragon Health Research Institute (IIS Aragon), Spain. jgotor89@gmail.com.
FAU - Lafuente, Miguel
AU  - Lafuente M
AD  - Department of Statistical Methods, University of Zaragoza, Zaragoza, Spain.. 
      miguellafuenteblasco@gmail.com.
FAU - Llorente, Monica
AU  - Llorente M
AD  - Department of Digestive Diseases, Miguel Servet University Hospital, Zaragoza, 
      Spain.. mllorentebarrio@gmail.com.
FAU - Sanz-Segura, Patricia
AU  - Sanz-Segura P
AD  - Department of Digestive Diseases. Miguel Servet University Hospital. Zaragoza; 
      Aragon Health Research Institute (IIS Aragon), Spain. 
      patricia.sanz.segura@gmail.com.
FAU - Monzon, Rosario
AU  - Monzon R
AD  - Department of Digestive Diseases, Miguel Servet University Hospital, Zaragoza, 
      Spain.. famoba@hotmail.es.
FAU - Horndler, Carlos
AU  - Horndler C
AD  - Department of Pathology, Miguel Servet University Hospital, Zaragoza, Spain. 
      chorndler@hotmail.com.
FAU - Pena-Galo, Edgar Martin
AU  - Pena-Galo EM
AD  - Aragon Health Research Institute (IIS Aragon), Spain. empenag@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20210618
PL  - Romania
TA  - J Gastrointestin Liver Dis
JT  - Journal of gastrointestinal and liver diseases : JGLD
JID - 101272825
RN  - 0 (Anti-Bacterial Agents)
RN  - 0 (Proton Pump Inhibitors)
RN  - EC 3.5.1.5 (Urease)
SB  - IM
MH  - Anti-Bacterial Agents
MH  - *Helicobacter Infections/diagnosis/drug therapy
MH  - *Helicobacter pylori
MH  - Humans
MH  - Prospective Studies
MH  - Proton Pump Inhibitors
MH  - Sensitivity and Specificity
MH  - Urease
EDAT- 2021/06/27 06:00
MHDA- 2022/01/15 06:00
CRDT- 2021/06/26 17:05
PHST- 2020/10/26 00:00 [received]
PHST- 2021/03/25 00:00 [accepted]
PHST- 2021/06/26 17:05 [entrez]
PHST- 2021/06/27 06:00 [pubmed]
PHST- 2022/01/15 06:00 [medline]
AID - 10.15403/jgld-3161 [doi]
PST - epublish
SO  - J Gastrointestin Liver Dis. 2021 Jun 18;30(2):198-204. doi: 10.15403/jgld-3161.