Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jun 21, 2010; 16(23): 2926-2930
Published online Jun 21, 2010. doi: 10.3748/wjg.v16.i23.2926
Dual specimens increase the diagnostic accuracy and reduce the reaction duration of rapid urease test
Wen-Hung Hsu, Sophie SW Wang, Chao-Hung Kuo, Chiao-Yun Chen, Ching-Wen Chang, Huang-Ming Hu, Jaw-Yuan Wang, Yuan-Chieh Yang, Yu-Chun Lin, Wen-Ming Wang, Deng-Chyang Wu, Ming-Tsang Wu, Fu-Chen Kuo
Wen-Hung Hsu, Sophie SW Wang, Chao-Hung Kuo, Ching-Wen Chang, Huang-Ming Hu, Yu-Chun Lin, Wen-Ming Wang, Deng-Chyang Wu, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan, China
Wen-Hung Hsu, Chao-Hung Kuo, Huang-Ming Hu, Wen-Ming Wang, Division of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 807, Taiwan, China
Sophie SW Wang, Chao-Hung Kuo, Chiao-Yun Chen, Deng-Chyang Wu, Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan, China
Chao-Hung Kuo, Wen-Ming Wang, Deng-Chyang Wu, Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan, China
Chiao-Yun Chen, Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan, China
Jaw-Yuan Wang, Division of Gastrointestinal and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan, China
Yuan-Chieh Yang, Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan, China
Ming-Tsang Wu, Fu-Chen Kuo, Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung 807, Taiwan, China
Fu-Chen Kuo, Department of Gynecology and Obstetrics, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan, China
Author contributions: Hsu WH, Wu DC and Kuo FC designed the study, collected and analyzed the data, and supervised the collection; Hsu WH and Wang SSW wrote the manuscript; Kuo CH, Chen CY, Chang CW, Hu HM, Wang JY, Yang YC, Lin YC, Wu MT and Wang WM participated in the design and coordination, and supervised the study; all authors have approved the final draft submitted.
Supported by A Grant from Kaohsiung Medical University Hospital (M094015, 94-KMUH-032, KMUH95-5D51), and E-Da Hospital (EDAH-D-97(P)014A) and Excellence for cancer research center grant, No. DOH99-TD-C-111-002, Department of Health, Executive Yuan, Taiwan
Correspondence to: Dr. Fu-Chen Kuo, Chief, Department of Gynecology and Obstetrics, E-Da Hospital, I-Shou University, No.1, Yida Rd., Yanchao Shiang, Kaohsiung 824, Taiwan, China. fuchenkuotw@yahoo.com.tw
Telephone: +886-7-6150011 Fax: +886-7-6155352
Received: January 5, 2010
Revised: February 10, 2010
Accepted: February 17, 2010
Published online: June 21, 2010
Abstract

AIM: To evaluate the influence of multiple samplings during esophagogastroduodenoscopy (EGD) on the accuracy of the rapid urease test, and the validity of newly developed rapid urease tests, HelicotecUT plus test and HelicotecUT test, CLO test and ProntoDry test.

METHODS: A total of 355 patients undergoing EGD for dyspepsia were included. Their Helicobacter pylori (H. pylori) treatment status was either naïve or eradicated. Six biopsy specimens from antrum and gastric body, respectively, were obtained during EGD. Single antral specimens and dual (antrum + body) specimens were compared. Infection status of H. pylori was evaluated by three different tests: culture, histology, and four different commercially available rapid urease tests (RUTs)-including the newly developed HelicotecUT plus test and HelicotecUT test, and established CLO test and ProntoDry test. H. pylori status was defined as positive when the culture was positive or if there were concordant positive results among histology, CLO test and ProntoDry test.

RESULTS: When dual specimens were applied, sensitivity was enhanced and RUT reaction time was significantly reduced, regardless of their treatment status. Thirty minutes were enough to achieve an agreeable positive rate in all the RUTs. Both newly developed RUTs showed comparable sensitivity, specificity and accuracy to the established RUTs, regardless of patient treatment status, RUT reaction duration, and EGD biopsy sites.

CONCLUSION: Combination of antrum and body biopsy specimens greatly enhances the sensitivity of rapid urease test and reduces the reaction duration to 30 min.

Keywords: Rapid urease test, Helicobacter pylori eradication, HelicotecUT plus test, HelicotecUT test, Esophagogastroduodenoscopy