Accuracy of Diagnostic Tests for Helicobacter Pylori Comparison Between Histology and Rapid Urease Test in Chonburi Hospital.
Keywords:
Helicobacter pylori, Histology, Rapid urease test, accuracy, sensitivity, specificityAbstract
Background: Helicobacter Pylori is one of the most common risk factors causing upper gastrointestinal diseases such as gastritis, duodenitis, gastric/duodenal ulcer, upper gastrointestinal bleeding, and gastric cancer.
Objective: To determine the sensitivity and specificity of the rapid urease test (Pyloplus) and comparing with histopathological results in a diagnosis of Helicobacter pylori infection in Chonburi Hospital.
Method: A retrospective cohort study comparing the sensitivity and specificity between rapid urease test and histopathological assessment for diagnosis of Helicobacter pylori in patients who underwent upper gastrointestinal endoscopy at Chonburi Hospital Patients presented with dyspepsia, gastroesophageal reflux disease, upper gastrointestinal bleeding, and iron deficiency anemia, between Oct 2022-Sep 2023.were included in the study.
Results: Seven hundred and eighty-six patients were enrolled. One hundred and ninety-four patients had positive tests for Helicobacter Pylori infection either by using rapid urease test or histopathology. The multivariate analysis showed that NSAIDs use (odd ratio 2.1, Cl1.29-3.17, p-value=0.002) and smoking (odd ratio 2.4, Cl 1.3-4.16, p-value=0.002) were the independent factors associated with Helicobacter pylori infection. This study revealed that histopathology assessment has an accuracy, sensitivity, and specificity of 98.3%, 93.3%, and 100% respectively. Furthermore, the rapid urease test has an accuracy, sensitivity, and specificity of 92.5%, 84.5%, and 100%respectively. From the univariate analysis, NSAIDs use (odd ratio 2.1, Cl 1.29-3.17, p-value=0.002) was the only independent variable associated with positive histological result but negative rapid urease test.
Conclusion: When comparing between two tests, the accuracy, sensitivity, and specificity of the rapid urease test in the detection of Helicobacter Pylori infection were not different with histopathology. However, it is more cost-saving than histopathology.
Keywords: Helicobacter pylori, Histology, Rapid urease test, accuracy, sensitivity, specificity.
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