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, 19 (4), 309-17

The Diagnostic Validity of the (13)c-urea Breath Test in the Gastrectomized Patients: Single Tertiary Center Retrospective Cohort Study


The Diagnostic Validity of the (13)c-urea Breath Test in the Gastrectomized Patients: Single Tertiary Center Retrospective Cohort Study

Yong Hwan Kwon et al. J Cancer Prev.


Background: This study was conducted to evaluate the diagnostic validity of the (13)C-urea breath test ((13)C-UBT) in the remnant stomach after partial gastrectomy for gastric cancer.

Methods: The (13)C-UBT results after Helicobacter pylori eradication therapy was compared with the results of endoscopic biopsy-based methods in the patients who have received partial gastrectomy for the gastric cancer.

Results: Among the gastrectomized patients who showed the positive (13)C-UBT results (≥ 2.5‰, n = 47) and negative (13)C-UBT results (< 2.5‰, n = 114) after H. pylori eradication, 26 patients (16.1%) and 4 patients (2.5%) were found to show false positive and false negative results based on biopsy-based methods, respectively. The sensitivity, specificity, false positive rate, and false negative rate for the cut-off value of 2.5‰ were 84.0%, 80.9%, 19.1%, and 16.0%, respectively. The positive and negative predictive values were 44.7% and 96.5%, respectively. In the multivariate analysis, two or more H. pylori eradication therapies (odds ratio = 3.248, 95% confidence interval= 1.088-9.695, P = 0.035) was associated with a false positive result of the (13)C-UBT.

Conclusions: After partial gastrectomy, a discordant result was shown in the positive (13)C-UBT results compared to the endoscopic biopsy methods for confirming the H. pylori status after eradication. Additional endoscopic biopsy-based H. pylori tests would be helpful to avoid unnecessary treatment for H. pylori eradication in these cases.

Keywords: 13C-urea breath test; Cut-off value; Eradication; Helicobacter pylori; Subtotal gastrectomy.


Figure 1.
Figure 1.
Flow chart of 13C-urea breath test (13C-UBT) and endoscopic biopsy based results of Helicobacter pylori (H. pylori) status after eradication in the partial gastrectomized patients. CLO, rapid urease test (Campylobacter-like organism).
Figure 2.
Figure 2.
Individual values of the false positive 13C-urea breath test (13C-UBT) results after Helicobacter pylori (H. pylori) eradication in the partial gastrectomized patients (median 13C-UBT value = 5.9‰).

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