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©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
Polymerase chain reaction: A sensitive method for detecting Helicobacter pylori infection in bleeding peptic ulcers
Ching-Chu Lo, Kwok-Hung Lai, Nan-Jing Peng, Gin-Ho Lo, Hui-Hwa Tseng, Chiun-Ku Lin, Chang-Bih Shie, Chao-Ming Wu, Yu-Shan Chen, Wen-Keui Huang, Angela Chen, Ping-I Hsu
Ching-Chu Lo, Kwok-Hung Lai, Gin-Ho Lo, Chiun-Ku Lin, Chang-Bih Shie, Chao-Ming Wu, Yu-Shan Chen, Ping-I Hsu, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veternans General Hospital, National Yang-Ming University, Taiwan, China
Nan-Jing Peng, Department of Nuclear Medicine, Kaohsiung Veternans General Hospital, National Yang-Ming University, Taiwan, China
Hui-Hwa Tseng, Department of Pathology, Kaohsiung Veternans General Hospital, National Yang-Ming University, Taiwan, China Wen-Keui Huang, Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veternans General Hospital, National Yang-Ming University, Taiwan, China
Angela Chen, Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by the Research Foundation of Kaohsiung Veterans General Hospital, No. VGHKS-91-35 and No. VTY88-G3-2, VGH-NYMU Joint Research Program, Taiwan, China
Correspondence to: Ping-I Hsu, Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung, 813, Taiwan, China. williamhsup@yahoo.com.tw
Telephone: +886-7-3422121-2075 Fax: +886-7-3468237
Received: February 23, 2004
Revised: April 10, 2004
Accepted: April 14, 2004
Published online: July 7, 2005
AIM: To assess the sensitivity and specificity of polymerase chain reaction (PCR) in detecting Helicobacter pylori (H pylori) infection in patients with bleeding peptic ulcers, and to compare its diagnostic efficacy with other invasive and non-invasive tests.
METHODS: From April to September 2002, H pylori status in 60 patients who consecutively presented with gastroduodenal ulcer bleeding was examined by rapid urease tests (RUT), histology, culture, PCR, serology and urea breath tests (UBT).
RESULTS: The sensitivity of PCR was significantly higher than that of RUT, histology and culture (91% vs 66%, 43% and 37%, respectively; P = 0.01, < 0.001, < 0.001, respectively), but similar to that of serology (94%) and UBT (94%). Additionally, PCR exhibited a greater specificity than serology (100% vs 65%, P < 0.01). However, the specificity of PCR did not differ from that of other tests. Further analysis revealed significant differences in the sensitivities of RUT, culture, histology and PCR between the patients with and those without blood in the stomach (P < 0.01, P = 0.09, P < 0.05, and P < 0.05, respectively).
CONCLUSION: PCR is the most accurate method among the biopsy-based tests to detect H pylori infection in patients with bleeding peptic ulcers. Blood may reduce the sensitivities of all biopsy-based tests.
