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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 28, 2015; 21(40): 11221-11235
Published online Oct 28, 2015. doi: 10.3748/wjg.v21.i40.11221
Diagnosis of Helicobacter pylori infection: Current options and developments
Yao-Kuang Wang, Fu-Chen Kuo, Chung-Jung Liu, Meng-Chieh Wu, Hsiang-Yao Shih, Sophie SW Wang, Jeng-Yih Wu, Chao-Hung Kuo, Yao-Kang Huang, Deng-Chyang Wu
Yao-Kuang Wang, Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 812, Taiwan
Yao-Kuang Wang, Chung-Jung Liu, Meng-Chieh Wu, Hsiang-Yao Shih, Sophie SW Wang, Jeng-Yih Wu, Chao-Hung Kuo, Deng-Chyang Wu, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
Fu-Chen Kuo, School of Medicine, College of Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan
Meng-Chieh Wu, Hsiang-Yao Shih, Deng-Chyang Wu, Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 801, Taiwan
Sophie SW Wang, Chao-Hung Kuo, Deng-Chyang Wu, Cancer for Stem Cell Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
Sophie SW Wang, Deng-Chyang Wu, Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
Yao-Kang Huang, Division of Gastroenterology, Department of Internal Medicine, Ten Chan Hospital, Chung-Li, Taoyuan 320, Taiwan
Author contributions: Wang YK wrote this manuscript; Kuo FC, Liu CJ, Wu MC, Shih HY, Wang SSW, Wu JY and Kuo CH designed research; Huang YK and Wu DC polished the paper; Huang YK and Wu DC equally contributed to this manuscript.
Supported by (in part) Grants from the Kaohsiung Medical University “Aim for the Top Universities Grant”, grant No. KMU-TP104G00, No. KMU-TP104G03 and No. KMU-TP104E25; and Ten Chan General Hospital, Chung-Li and KMU Joint Research Project, No. ST102004; and Kaohsiung Medical University Hospital, No. KMUH100-0R01.
Conflict-of-interest statement: The authors have no conflict of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Deng-Chyang Wu, MD, PhD, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, 100 Tz-You 1st road, Kaohsiung 807, Taiwan. dechwu@yahoo.com
Telephone: +886-7-3121101-7451 Fax: +886-7-3135612
Received: April 29, 2015
Peer-review started: May 12, 2015
First decision: July 13, 2015
Revised: August 6, 2015
Accepted: September 28, 2015
Article in press: September 30, 2015
Published online: October 28, 2015
Processing time: 176 Days and 21.6 Hours
Abstract

Accurate diagnosis of Helicobacter pylori (H. pylori) infection is a crucial part in the effective management of many gastroduodenal diseases. Several invasive and non-invasive diagnostic tests are available for the detection of H. pylori and each test has its usefulness and limitations in different clinical situations. Although none can be considered as a single gold standard in clinical practice, several techniques have been developed to give the more reliable results. Invasive tests are performed via endoscopic biopsy specimens and these tests include histology, culture, rapid urease test as well as molecular methods. Developments of endoscopic equipment also contribute to the real-time diagnosis of H. pylori during endoscopy. Urea breathing test and stool antigen test are most widely used non-invasive tests, whereas serology is useful in screening and epidemiological studies. Molecular methods have been used in variable specimens other than gastric mucosa. More than detection of H. pylori infection, several tests are introduced into the evaluation of virulence factors and antibiotic sensitivity of H. pylori, as well as screening precancerous lesions and gastric cancer. The aim of this article is to review the current options and novel developments of diagnostic tests and their applications in different clinical conditions or for specific purposes.

Keywords: Helicobacter pylori; Diagnosis; Invasive; Noninvasive; Oral specimen; Bleeding; Gastrectomy; Eradication

Core tip: Nowadays, several tests are available for the diagnosis of Helicobacter pylori (H. pylori) infection. In this review, we focus on the usefulness and limitations of current diagnostic methods as well as the recent developments of these tests that contribute to improve the diagnostic accuracy. Furthermore, we also emphasize the detection of H. pylori in oral specimens and in patients with different clinical circumstances, including bleeding, post-gastrectomy and post-eradication therapy.