Expertos Invitados





ANALIZAN LA EXACTITUD DE LA PRUEBA DEL ALIENTO CON 13C-UREA PARA DIAGNOSTICO DE LA INFECCION POR H. PYLORI MEDIANTE ESPECTROMETRIA DE MASA Y ESPECTROFOTOMETRIA DE INFRARROJO

(especial para SIIC © Derechos reservados)
La prueba del aliento con urea tiene una exactitud mayor del 90%, por lo que es superior al diagnóstico basado en el análisis de la muestra obtenida por biopsia.
gisbert9.jpg Autor:
Javier p. Gisbert
Columnista Experto de SIIC

Institución:
Hospital Universitario de la Princesa, Universidad Autónoma de Madrid

Artículos publicados por Javier p. Gisbert
Recepción del artículo
14 de Febrero, 2006 		Aprobación
4 de Mayo, 2006
Primera edición
3 de Julio, 2006 		Segunda edición, ampliada y corregida
7 de Junio, 2021

ANALIZAN LA EXACTITUD DE LA PRUEBA DEL ALIENTO CON 13C-UREA PARA DIAGNOSTICO DE LA INFECCION POR H. PYLORI MEDIANTE ESPECTROMETRIA DE MASA Y ESPECTROFOTOMETRIA DE INFRARROJO

Resumen
La prueba del aliento con urea (PAU) se basa en la capacidad de la ureasa producida por H. pylori para hidrolizar una solución de urea previamente marcada con el isótopo 13C o 14C. La utilización de 13C comporta indudables ventajas, ya que se trata de un isótopo natural estable y no radiactivo. La PAU es considerada actualmente como la técnica de elección para confirmar la erradicación de H. pylori (cuando no es precisa la gastroscopia), lo que deberá comprobarse al menos cuatro semanas después de haber finalizado el tratamiento antibiótico. La exactitud diagnóstica de la PAU es muy elevada, superior al 90%, probablemente debido a que valora la totalidad de la mucosa gástrica, a diferencia de los métodos diagnósticos basados en el análisis de la muestra obtenida por biopsia. Para la realización de la PAU se emplea tradicionalmente un espectrómetro de masas de relaciones isotópicas (isotope ratio mass spectrometer [IRMS]). Más recientemente se desarrollaron otras técnicas, entre las que destaca la espectrofotometría de infrarrojos (NDIRS). Ambos equipos poseen una similar y elevada exactitud diagnóstica. La utilización del IRMS podría ser más apropiada en hospitales donde se realicen numerosas pruebas del aliento o en aquellos sitios que actúen como centros de referencia para la recepción de muestras procedentes de otros lugares. El NDIRS, por su parte, constituye una atractiva alternativa para los laboratorios que procesan un reducido número de muestras o para el uso en la propia consulta.

Palabras clave
helicobacter pylori, diagnóstico, prueba del aliento, 13C-urea, espectrómetro de masas, infrarrojos


Artículo completo
(castellano)
Extensión:  +/-6.96 páginas impresas en papel A4
Exclusivo para suscriptores/assinantes
Clasificación en siicsalud
Artículos originales > Expertos de Iberoamérica >
página   www.siicsalud.com/des/expertocompleto.php/

Especialidades
Principal: Gastroenterología
Relacionadas: Bioquímica, Diagnóstico por Laboratorio, Infectología, Medicina Interna



Comprar este artículo
Extensión: 6.96 páginas impresas en papel A4

file05.gif (1491 bytes) Artículos seleccionados para su compra



Enviar correspondencia a:
Javier P. Gisbert, Servicio de Aparato Digestivo, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, 28669, Playa de Mojácar 29, Urb. Bonanza, Boadilla del Monte, Madrid, España
Bibliografía del artículo
1. Gisbert JP. Revisión crítica de los métodos diagnósticos de infección por Helicobacter pylori. Gastroenterol Hepatol 2000; 23:135-43.
2. Logan RP. Urea breath tests in the management of Helicobacter pylori infection. Gut 1998; 43 Suppl 1:S47-50.
3. Perri F, Festa V, Clemente R, Quitadamo M, Andriulli A. Methodological problems and pitfalls of urea breath test. Ital J Gastroenterol Hepatol 1998; 30 Suppl 3:S315-9.
4. Savarino V, Vigneri S, Celle G. The 13C urea breath test in the diagnosis of Helicobacter pylori infection. Gut 1999; 45 Suppl 1:I18-22.
5. Gisbert JP, Pajares JM. Review article: C-urea breath test in the diagnosis of Helicobacter pylori infection - a critical review. Aliment Pharmacol Ther 2004; 20:1001-17.
6. Canete A, Abunaji Y, Alvarez Calatayud G, DeVicente M, González Holguera JA, Leralta M, et al. Breath test using a single 50-mg dose of 13C-urea to detect Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr 2003; 36:105-11.
7. Gomollón F, Ducons JA, Santolaria S, Lera Omiste I, Guirao R, Ferrero M, et al. Breath test is very reliable for diagnosis of Helicobacter pylori infection in real clinical practice. Dig Liver Dis 2003; 35:612-8.
8. Mones J, Gisbert JP, Borda F, Domínguez Muñoz E. Indications, diagnostic tests and Helicobacter pylori eradication therapy. Recommendations by the 2nd Spanish Consensus Conference. Rev Esp Enferm Dig 2005; 97:348-74.
9. Malfertheiner P, Megraud F, O'Morain C, Hungin AP, Jones R, Axon A, et al. Current concepts in the management of Helicobacter pylori infection. The Maastricht 2-2000 Consensus Report. Aliment Pharmacol Ther 2002; 16:167-180.
10. Atherton JC. Non-endoscopic tests in the diagnosis of Helicobacter pylori infection. Aliment Pharmacol Ther 1997; 11 Suppl 1:11-20.
11. Atherton JC, Spiller RC. The urea breath test for Helicobacter pylori. Gut 1994; 35:723-5.
12. Pérez García JI, Pajares García JM, Jiménez Alonso I. Prueba del aliento con urea marcada con 13C para el diagnóstico en la infección por H. pylori en la mucosa gástrica. Validación del método. Rev Esp Enferm Dig 1996; 88:202-8.
13. Bazzoli F, Zagari M, Fossi S, Pozzato P, Ricciardiello L, Mwangemi C, et al. Urea breath tests for the detection of Helicobacter pylori infection. Helicobacter 1997; 2 Suppl 1:S34-7.
14. Thomas JE. 13C urea breath test. Gut 1998; 43 Suppl 3:S7-12.
15. Bell GD. Clinical practice-breath tests. Br Med Bull 1998; 54:187-93.
16. Bazzoli F, Zagari M, Pozzato P, Fossi S, Ricciardiello GL, Nicolini G, et al. Diagnosis of Helicobacter pylori infection: non-invasive diagnostic tests. Ital J Gastroenterol Hepatol 1998; 30 Suppl 3:S313-4.
17. Perri F. Diagnosis of Helicobacter pylori infection: which is the best test? The urea breath test. Dig Liver Dis 2000; 32 Suppl 3:S196-8.
18. Graham DY, Klein PD. Accurate diagnosis of Helicobacter pylori. 13C-urea breath test. Gastroenterol Clin North Am 2000; 29:885-93.
19. Parente F, Bianchi Porro G. The (13)C-urea breath test for non-invasive diagnosis of Helicobacter pylori infection: which procedure and which measuring equipment? Eur J Gastroenterol Hepatol 2001; 13:803-6.
20. Gisbert JP, Ducons J, Gomollón F, Domínguez Muñoz JE, Borda F, Mino G, et al. Validation of the 13C-urea breath test for the initial diagnosis of Helicobacter pylori infection and to confirm eradication after treatment. Rev Esp Enferm Dig 2003; 95:115-20.
21. Graham DY, Klein PD, Evans DJ, Jr., Evans DG, Alpert LC, Opekun AR, et al. Campylobacter pylori detected noninvasively by the 13C-urea breath test. Lancet 1987; 1:1174-7.
22. Wong WM, Wong BC, Li TM, Wong KW, Cheung KL, Fung FM, et al. Twenty-minute 50 mg 13C-urea breath test without test meal for the diagnosis of Helicobacter pylori infection in Chinese. Aliment Pharmacol Ther 2001; 15:1499-504.
23. Sheu BS, Lee SC, Yang HB, Wu HW, Wu CS, Lin XZ, et al. Lower-dose (13)C-urea breath test to detect Helicobacter pylori infection-comparison between infrared spectrometer and mass spectrometry analysis. Aliment Pharmacol Ther 2000; 14:1359-63.
24. Liao CC, Lee CL, Chiang TC, Lee SC, Huang SH, Tu TC, et al. The 13C-urea breath test to detect Helicobacter pylori infection: a validated simple methodology with 50 mg 13C-urea. Aliment Pharmacol Ther 2002; 16:787-92.
25. Gatta L, Vakil N, Ricci C, Osborn JF, Tampieri A, Perna F, et al. A rapid, low-dose, 13C-urea tablet for the detection of Helicobacter pylori infection before and after treatment. Aliment Pharmacol Ther 2003; 17:793-8.
26. Wong WM, Lam SK, Lai KC, Chu KM, Xia HH, Wong KW, et al. A rapid-release 50-mg tablet-based 13C-urea breath test for the diagnosis of Helicobacter pylori infection. Aliment Pharmacol Ther 2003; 17:253-7.
27. Gatta L, Vakil N, Ricci C, Osborn JF, Tampieri A, Perna F, et al. Effect of proton pump inhibitors and antacid therapy on C urea breath tests and stool test for Helicobacter pylori infection. Am J Gastroenterol 2004; 99:823-829.
28. Peng NJ, Lai KH, Liu RS, Lee SC, Tsay DG, Lo CC, et al. Capsule 13C-urea breath test for the diagnosis of Helicobacter pylori infection. World J Gastroenterol 2005; 11:1361-4.
29. Domínguez Muñoz JE, Leodolter A, Sauerbruch T, Malfertheiner P. A citric acid solution is an optimal test drink in the 13C-urea breath test for the diagnosis of Helicobacter pylori infection. Gut 1997; 40:459-62.
30. Graham DY, Runke D, Anderson SY, Malaty HM, Klein PD. Citric acid as the test meal for the 13C-urea breath test. Am J Gastroenterol 1999; 94:1214-7.
31. Eggers RH, Kukp A, Tegeler R, Lüdtke FE, Lepsien G, Meyer B. A methodological analysis of the 13C-urea breath tests for detection of Helicobacter pylori infections: high sensitivity and specificity within 30 minutes using 75 mg of 13C-urea. Eur J Gastroenterol Hepatol 1990; 2:437-444.
32. Leodolter A, Domínguez Muñoz JE, Von Arnim U, Malfertheiner P. Citric acid or orange juice for the 13C-urea breath test: the impact of pH and gastric emptying. Aliment Pharmacol Ther 1999; 13:1057-62.
33. Hamlet A, Stage L, Lonroth H, Cahlin C, Nystrom C, Pettersson A. A novel tablet-based 13C urea breath test for Helicobacter pylori with enhanced performance during acid suppression therapy. Scand J Gastroenterol 1999; 34:367-74.
34. Chey WD, Chathadi KV, Montague J, Ahmed F, Murthy U. Intragastric acidification reduces the occurrence of false-negative urea breath test results in patients taking a proton pump inhibitor. Am J Gastroenterol 2001; 96:1028-32.
35. Gisbert JP, Vázquez MA, Jiménez I, Cruzado AI, Carpio D, Del Castillo E, et al. 13C-urea breath test for the diagnosis of Helicobacter pylori infection before treatment: is citric acid necessary? Dig Liver Dis 2000; 32:20-4.
36. Shirin H, Levine A, Shevah O, Shabat-Sehayek V, Aeed H, Wardi J, et al. Eradication of Helicobacter pylori can be accurately confirmed 14 days after termination of triple therapy using a high-dose citric acid-based C urea breath test. Digestion 2005; 71:208-12.
37. Malaty HM, el-Zimaity HM, Genta RM, Klein PD, Graham DY. Twenty-minute fasting version of the US 13C-urea breath test for the diagnosis of H. pylori infection. Helicobacter 1996; 1:165-7.
38. Oksanen A, Bergstrom M, Sjostedt S, Gad A, Hammarlund B, Seensalu R. Accurate detection of Helicobacter pylori infection with a simplified 13C urea breath test. Scand J Clin Lab Invest 1997; 57:689-94.
39. Miwa H, Murai T, Ohkura R, Nagahara A, Watanabe H, Terai T, et al. Usefulness of the [13C]-urea breath test for detection of Helicobacter pylori infection in fasting patients. J Gastroenterol Hepatol 1998; 13:1039-43.
40. Casellas F, López J, Borruel N, Saperas E, Vergara M, De Torres I, et al. The impact of delaying gastric emptying by either meal substrate or drug on the [13C]-urea breath test. Am J Gastroenterol 1999; 94:369-73.
41. Wong WM, Wong BC, Wong KW, Fung FM, Lai KC, Hu WH, et al. (13)C-urea breath test without a test meal is highly accurate for the detection of Helicobacter pylori infection in Chinese. Aliment Pharmacol Ther 2000; 14:1353-8.
42. Wang WM, Lee SC, Wu DC, Chen LT, Liu CS, Peng CF, et al. Simplified 13C-urea breath test for the diagnosis of Helicobacter pylori infection-the availability of without fasting and without test meal. Kaohsiung J Med Sci 2000; 16:607-13.
43. Ng FH, Lai KC, Wong BC, Wong WM, Wong SY, Chow KC, et al. [13C]-urea breath test without prior fasting and without test meal is accurate for the detection of Helicobacter pylori infection in Chinese. J Gastroenterol Hepatol 2002; 17:834-8.
44. Chen TS, Chang FY, Chen PC, Huang TW, Ou JT, Tsai MH, et al. Simplified 13C-urea breath test with a new infrared spectrometer for diagnosis of Helicobacter pylori infection. J Gastroenterol Hepatol 2003; 18:1237-43.
45. Menegatti M, Stanghellini V, Landi F, Farinelli S, Mucci F, Ali A. 13C with and without test meal vs 14C urea breath test (UBT) to detect H. pylori before and after treatment. Gut 1997; 41(suppl.3):A162.
46. Gisbert JP, Gomollón F, Domínguez Muñoz JE, Borda F, Jiménez I, Vázquez MA, et al. Comparison between two 13C-urea breath tests for the diagnosis of Helicobacter pylori infection: isotope ratio mass spectrometer versus infrared spectrometer. Gastroenterol Hepatol 2003; 26:141-6.
47. Braden B, Haisch M, Duan LP, Lembcke B, Caspary WF, Hering P. Clinically feasible stable isotope technique at a reasonable price: analysis of 13CO2/12CO2-abundance in breath samples with a new isotope selective-nondispersive infrared spectrometer. Z Gastroenterol 1994; 32:675-8.
48. Koletzko S, Haisch M, Seeboth I, Braden B, Hengels K, Koletzko B, et al. Isotope-selective non-dispersive infrared spectrometry for detection of Helicobacter pylori infection with 13C-urea breath test. Lancet 1995; 345:961-2.
49. Taniguchi Y, Kimura K, Sohara H, Shirasaki A, Kawada H, Satoh K, et al. Simple 13C-urea breath test with infra-red spectrophotometer. J Gastroenterol 1996; 31 Suppl 9:37-40.
50. Braden B, Schafer F, Caspary WF, Lembcke B. Nondispersive isotope-selective infrared spectroscopy: a new analytical method for 13C-urea breath tests. Scand J Gastroenterol 1996; 31:442-5.
51. Hildebrand P, Beglinger C. Nondispersive infrared spectrometry: a new method for the detection of Helicobacter pylori infection with the 13C-urea breath test. Clin Infect Dis 1997; 25:1003-5.
52. Ohara S, Kato M, Asaka M, Toyota T. The UBiT-100 13CO2 infrared analyzer: comparison between infrared spectrometric analysis and mass spectrometric analysis. Helicobacter 1998; 3:49-53.
53. Savarino V, Mela GS, Zentilin P, Bisso G, Pivari M, Mansi C, et al. Comparison of isotope ratio mass spectrometry and nondispersive isotope- selective infrared spectroscopy for 13C-urea breath test [see comments]. Am J Gastroenterol 1999; 94:1203-8.
54. Mion F, Ecochard R, Guitton J, Ponchon T. (13)CO(2) breath tests: comparison of isotope ratio mass spectrometry and non-dispersive infrared spectrometry results. Gastroenterol Clin Biol 2001; 25:375-9.
55. Hartmann D, Schilling D, Riemann JF. New nondispersive infrared spectrometry in 13C-urea breath tests. Dtsch Med Wochenschr 2003; 128:1645-8.
56. Isomoto H, Inoue K, Mizuta Y, Nakazato M, Kanazawa Y, Nishiyama H, et al. Validation of endoscopic 13C-urea breath test with nondispersive infrared spectrometric analysis in the management of Helicobacter pylori infection. Hepatogastroenterology 2003; 50:422-5.
57. Braden B, Caspary WF, Lembcke B. Nondispersive infrared spectrometry for 13CO2/12CO2-measurements: a clinically feasible analyzer for stable isotope breath tests in gastroenterology. Z Gastroenterol 1999; 37:477-81.
58. Kato M, Saito M, Fukuda S, Kato C, Ohara S, Hamada S, et al. 13C-Urea breath test, using a new compact nondispersive isotope-selective infrared spectrophotometer: comparison with mass spectrometry. J Gastroenterol 2004; 39:629-34.
59. Coelho LG, Reber M, Passos MC, Aguiar RO, Casaes PE, Bueno ML, et al. Application of isotope-selective non-dispersive infrared spectrometry for the evaluation of the 13C-urea breath test: comparison with three concordant methods. Braz J Med Biol Res 1999; 32:1493-7.
60. Mana F, Franken PR, Ham HR, Reynaert H, Urbain D. 13C urea breath test with nondispersive isotope-selective infrared spectrometry: reproducibility and importance of the fasting status. Helicobacter 2000; 5:104-8.
61. Riepl RL, Folwaczny C, Otto B, Klauser A, Blendinger C, Wiebecke B, et al. Accuracy of 13C-urea breath test in clinical use for diagnosis of Helicobacter pylori infection. Z Gastroenterol 2000; 38:13-9.
62. Mana F, Franken PR, Ham HR, Urbain D. Cut-off point, timing and pitfalls of the 13C-urea breath test as measured by infrared spectrometry. Digest Liver Dis 2001; 33:30-35.
63. Machado RS, Patricio FR, Kawakami E. 13C-urea breaht test to diagnose Helicobacter pylori infection in children aged up to 6 years. Helicobacter 2004; 9:39-45.
64. Kawakami E, Machado RS, Reber M, Patricio FR. 13C-urea breath test with infrared spectroscopy for diagnosing Helicobacter pylori infection in children and adolescents. J Pediatr Gastroenterol Nutr 2002; 35:39-43.
65. Chang MC, Chang YT, Sun CT, Wu MS, Wang HP, Lin JT. Quantitative correlation of Helicobacter pylori stool antigen (HpSA) test with 13C-urea breath test (13C-UBT) by the updated Sydney grading system of gastritis. Hepatogastroenterology 2002; 49:576-9.
66. Bielanski W, Konturek SJ. New approach to 13C-urea breath test: capsule-based modification with low-dose of 13C-urea in the diagnosis of Helicobacter pylori infection. J Physiol Pharmacol 1996; 47:545-53.
67. Ellenrieder V, Glasbrenner B, Stoffels C, Weiler S, Bode G, Moller P, et al. Qualitative and semi-quantitative value of a modified 13C-urea breath test for identification of Helicobacter pylori infection. Eur J Gastroenterol Hepatol 1997; 9:1085-9.
68. Germana B, Galliani E, Lecis P, Costan F. Diagnosis of Helicobacter pylori infections using isotope-selective non dispersive infrared spectrometry with 13C-urea breath test. Recenti Prog Med 2001; 92:113-6.
69. Ohara H, Suzuki T, Nakagawa T, Yoneshima M, Yamamoto M, Tsujino D, et al. 13C-UBT using an infrared spectrometer for detection of Helicobacter pylori and for monitoring the effects of lansoprazole. J Clin Gastroenterol 1995; 20 Suppl 2:S115-7.
70. Opekun AR, Gotschall AB, Abdalla N, Agent C, Torres E, Sutton FM, et al. Improved infrared spectrophotometer for point-of-care patient (13)C-urea breath testing in the primary care setting. Clin Biochem 2005; 38:731-4.
Título español
Resumen
 Palabras clave
 Bibliografía
 Artículo completo
(exclusivo a suscriptores)
 Autoevaluación
  Tema principal en SIIC Data Bases
 Especialidades

  English title
  Abstract
  Key words
Full text
(exclusivo a suscriptores)

Autor 
Artículos
Correspondencia
Patrocinio y reconocimiento
Imprimir esta página
 
 
 
 
 
 
 
 
 
 
 
 
Está expresamente prohibida la redistribución y la redifusión de todo o parte de los contenidos de la Sociedad Iberoamericana de Información Científica (SIIC) S.A. sin previo y expreso consentimiento de SIIC.
ua31618
Inicio/Home

Copyright siicsalud © 1997-2024 ISSN siicsalud: 1667-9008