Comparative diagnostic performance of rapid urease test with the sweeping method versus tissue sampling method after Helicobacter pylori eradication.

BACKGROUND AND AIMS: The rapid urease test (RUT) is widely used to detect Helicobacter pylori (H. pylori) infection; however, it is not preferred as a monitoring strategy following eradication owing to its low sensitivity. In this study, we evaluated the diagnostic performance of RUT using the sweeping method, which overcomes the limitations of conventional tissue sampling methods following eradication.

METHODS: Patients who received H. pylori eradication treatment were enrolled. Each of the sweeping and conventional methods was performed on the same patients to compare diagnostic performance. Urea breath test (UBT), histology, and PCR were performed to determine true infection. Logistic regression analysis was conducted to investigate reasons for discrepancies between the results of the two methods.

RESULTS: In 216 patients, the eradication success rate was 68.1%, sensitivity and specificity of the sweeping method were 0.812 and 0.912, respectively, whereas those of the conventional method were 0.391 and 0.993, respectively (P<0.05 for all). AUROC for the sweeping method was higher than that for the conventional method (0.862 vs. 0.692; P<0.001). The mean time to H. pylori detection for the sweeping method was 4.7±4.4 min and 12.3±16.1 min for the conventional method (P<0.001). The risk for inconsistent results between the two methods was the highest in the UBT value 1.4-2.4‰ (OR 3.8, P=0.016).

CONCLUSIONS: The RUT with the sweeping method could potentially replace the tissue sampling method as a test to confirm H. pylori eradication and be an alternative option to UBT for patients requiring endoscopy.