Abstract
Background: Helicobacter pylori (H. pylori) is one of the main causes of gastritis, peptic ulcer and stomach cancer. Ultrafast urease tests (UUT) make it possible to simplify patient management by notifying the result after 5 minutes and entering it into the protocol of endoscopic conclusion. There is no data on the accuracy of UUT in the pediatric population. Aim of the study: to identify the accuracy of UUT in comparison with histological examination in children. Methods: a single-center retrospective study of children (4-18 years old) who underwent esophagogastroduodenoscopy with biopsy of the gastric antrum mucosa for H.pylori UUT, followed by histological examination. The reaction time stated by the manufacturers was estimated to be no more than 5 minutes for a positive result. Histology was the “gold” standard. Results: 211 patients were examined (boys n=103, 48.8%; girls n=108, 51.2%) average age 11.7 years (±3.5, 4-18 years). H.pylori infection was detected in 31 out of 211 patients. There was a significantly higher number of positive reactions of both UUT’s in the age group of children from 11 to 18 years old compared with the group of children from 4 to 10 years old. The sensitivity of AMA RUT Pro UUT was 18.7%, specificity 93.8%, negative and positive predictive value 82% and 42%, respectively, accuracy 79%. The sensitivity of the BioHit UFT300 UFUT was 40%, specificity 96.5%, negative and positive predictive value 92% and 60%, respectively, accuracy 90%. Conclusion: our data demonstrate the low sensitivity of ultrafast urease tests in children when using a single fragment of tissue from the gastric antrum in the five-minute reaction time allotted by manufacturers to a negative result. Perhaps sensitivity indicators can be improved by placing several fragments of the mucous membrane of the body and the antrum of the stomach on one test, which is a direction for future research.
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