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cost effectiveness analysis of population-based serology screening and ^(13)c-urea breath test for Helicobacter pylori to prevent gastric cancer:A markov model

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World Journal of Gastroenterology 2008年第19期14卷 3021-3027页

作者： Feng Xie Nan Luo Hin-Peng Lee Department of clinical Epidemiology and Biostatistics McMaster University Ontario L8P 1H 1 Canada Department of community Occupational and Family Medicine and Research Fellow Centre for Health Services Research Yong Lop Lin School of Medicine National University of Singapore Singapore 117597 Singapore Department of community Occupational and Family Medicine Yong Loo Lin School of Medicine National University of Singapore Singapore 117597 Singapore

AIM:To compare the costs and effectiveness of no screening and no eradication therapy, the population- based Helicobacter pylori (H pylori) serology screening with eradication therapy and 13c-urea breath test (UBT) with eradication therapy. METHODS:A Markov model simulation was carried out in all 237 900 chinese males with age between 35 and 44 from the perspective of the public healthcare provider in Singapore. The main outcome measures were the costs, number of gastric cancer cases prevented, life years saved, and quality-adjusted life years (QALYs) gained from screening age to death. The uncertainty surrounding the cost-effectiveness ratio was addressed by one-way sensitivity analyses. RESULTS:compared to no screening, the incremental cost-effectiveness ratio (IcER) was $16 166 per life year saved or $13 571 per QALY gained for the serology screening, and $38 792 per life year saved and $32 525 per QALY gained for the UBT. The IcER was $477 079 per life year saved or $390 337 per QALY gained for the UBT compared to the serology screening. The cost- effectiveness of serology screening over the UBT was robust to most parameters in the model. cONcLUSION:The population-based serologyscreening for H pylori was more cost-effective than the UBT in prevention of gastric cancer in Singapore chinese males.

关键词： cost-effectiveness analysis Gastric cancer He/icobacterpy/ori 13c-urea breath test Serology

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capsule ^(13)c-urea breath test for the diagnosis of Helicobacter pylori infection

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World Journal of Gastroenterology 2005年第9期11卷 1361-1364页

作者： Nan-JingPeng Kwok-HungLai Ren-ShyanLiu Shui-chengLee Daw-GueyTsay ching-chuLo Huei-HwaTseng Wen-KeuiHuang Gin-HoLo Ping-IHsu DepartmentofNuclearMedicine KaohsiungVeteransGeneralHospitalKaohsiungTaiwanChina DivisionofGastroenterology DepartmentofInternalMedicineKaohsiungVeteransGeneralHospitalKaohsiungTaiwanChina DepartmentofNuclearMedicine TaipeiVeteransGeneralHospitalandNationalYang-MingUniversityTaipeiTaiwanChina InstituteofNuclearEnergyResearch TaoyuanTaiwanChina DepartmentofPathologyandLaboratoryMedicine KaohsiungVeteransGeneralHospitalKaohsiungTaiwanChina

AIM: To compare the accuracy of capsule 13c-urea breath test (UBT) with conventional invasive methods for the diagnosis of Helicobacter pylori ***: One hundred patients received cLO test,histological examination, culture and 100- or 50-mg capsule UBT for the diagnosis of Hpyloriinfection. Hpylori infection was defined as those with positive culture or positive results from both histology and cLO ***: Both the sensitivity and specificity of the 100-mg capsule UBT (n = 50) were 100%. The sensitivity and specificity of the 50-mg capsule UBT (n = 50) were 96.4and 100%, respectively. Taken together, the accuracy of capsule UBT (n=100) was higher than that of cLO test,histology and culture (100% vs 92%, 91% and 89%,respectively; P= 0.035, 0.018 and 0.005, respectively). Our data showed that the optimal timing of sampling for 100-and 50-mg capsule UBT was 15-30 and 6-15 min, ***: capsule UBT has a higher accuracy compared with biopsy-based tests. It is an ideal method for the diagnosis of Hpyloriinfection.

关键词： 13c-urea breath test capsule Helicobacter pylori Oral urease

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breath and string test: A diagnostic package for the identification of treatment failure and antibiotic resistance of Helicobacter pylori without the necessity of upper gastrointestinal endoscopy

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World Journal of Gastroenterology 2005年第4期11卷 584-586页

作者： Andreas Leodolter Kathlen Wolle Ulrike von Arnim Stefan Kahl Gerhard Treiber Matthias P.Ebert Ulrich Peitz Peter Malfertheiner Department of Gastroenterology Hepatology and Infectious Diseases University of MagdeburgGermany

AIM: Helicobacter pylori (H pylori) resistance after failed eradication has a major impact on the outcome of a further treatment regimen. The aim of this study was to assess the validity of a non-invasive strategy using the 13c-urea breath test (UBT) and the gastric string test in identifying post-treatment resistance of H pylori. METHODS: The UBT was routinely performed 4 to 6 wk after H pylori eradication therapy. Forty-two patients (24 females, 18 males, mean age 48 years) with a positive UBT were included in the study. A gastric string test using a capsule containing a 90 cm-long nylon fiber was performed. Before the capsule was swallowed, the free end of the string was taped to the cheek. After one hour in the stomach, the string was withdrawn. The distal 20 cm of the string was inoculated onto an agar plate and processed under micro-aerophilic conditions. Following the string test, upper gastrointestinal endoscopy was performed to obtain gastric biopsies for conventional culture. RESULTS: H pylori was successfully cultured from the gastric string in 34 patients (81%), but not in 5 patients due to contamination with oropharyngeal flora. H py/oriwas cultured from the gastric biopsies obtained at endoscopy in 39 patients (93%). cONcLUSION: The UBT followed by the gastric string test in the case of treatment failure is a valid diagnostic strategy with the aim of determining the post-therapeutic antibiotic resistance of H pylori with little inconvenience to the patient. Upper Gl-endoscopy can be avoided in several cases by applying consequently this diagnostic package.

关键词： Helicobacter pylorr, Antibiotic resistance 13c-urea breath test Gastric string test

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Blood pressure and stature in Helicobacter pylori positive and negative persons

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World Journal of Gastroenterology 2014年第19期20卷 5625-5631页

作者： Marcela Kopacova Ilona Koupil Bohumil Seifert Miluska Skodova Fendrichova Jana Spirkova Viktor Vorisek Stanislav Rejchrt Tomas Douda Ilja Tacheci Jan Bures 2~(nd)Department of Internal Medicine-Gastroenterology Charles University in PrahaFaculty of Medicine at Hradec KraloveUniversity Teaching Hospital50005 Hradec KraloveCzech Republic centre for Health Equity Studies Stockholm UniversityKarolinska Institute17177 StockholmSweden Institute of General Practice First Faculty of MedicineCharles University12002 PrahaCzech Republic Institute of clinical Biochemistry and Diagnostics Charles University in PrahaFaculty of Medicine at Hradec KraloveUniversity Teaching Hospital50005 Hradec KraloveCzech Republic

To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the geographical distribution of the czech population. A total of 1818 subjects (aged 5-98 years) took part in the study, randomly selected out of 38147 subjects. H. pylori infection was investigated by means of a 13c-urea breath test. Data on height, weight, systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners. The overall prevalence of H. pylori infection was 30.4% (402/1321) in adults (≥ 18 year-old) and 5.2% (26/497) in children and adolescents (≤ 17 year-old). Once adjusted for age and gender, only a difference in body mass index remained statistically significant with H. pylori positive adults showing an increase of 0.6 kg/m2 in body mass index. Once adjusted for age and gender, we found a difference in height between H. pylori positive and H. pylori negative children and adolescents. On further adjustment for place of residence, this difference became statistically significant, with H. pylori positive children and adolescents being on average 3.5 cm shorter. H. pylori positive adults were significantly older compared to H. pylori negative subjects. Once adjusted for age and gender, H. pylori infection had no impact on body weight, body mass index and vital signs either in adults or children and adolescents. chronic H. pylori infection appeared to be associated with short stature in children. H. pylori infection did not influence blood pressure, body weight and body mass index either in adults or children and adolescents.

关键词： Epidemiology Helicobacter pylori czech Republic 13c-urea breath test Blood pressure Heart rate Weight Stature Body mass index

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Epidemiological investigation of Helicobacter pylori infection in elderly people in Beijing

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World Journal of clinical cases 2020年第11期8卷 2173-2180页

作者： Hong-Ming Zhu Bang-Yi Li Zhe Tang Jing She Xue-Ying Liang Li-Kou Dong Mei Zhang Department of Gastroenterology Xuanwu HospitalCapital Medical UniversityBeijing 100053China National Geriatric Disease clinical Medical Research center Xuanwu HospitalBeijing 100053China

BAcKGROUND The Helicobacter pylori(***)infection rate in china is approximately 50%.*** is a pathogenic factor of peptic ulcer and chronic *** addition,*** infection may also be associated with a variety of cardiovascular diseases in elderly people,such as arteriosclerosis,coronary heart disease,and cerebral infarction,having deleterious effect on their *** the aging of the population,the disease characteristics of the elderly population have been increasingly valued by the whole *** conducted an epidemiological survey of *** infection among elderly people in Beijing to provide a basis for health management of *** *** To understand the epidemiological characteristics of *** infection in elderly people in *** A total of 1090 elderly people aged more than 60 years from different parts of Beijing(urban and rural areas)were selected using the random cluster sampling *** questionnaires were completed during home visits and the 13c-urea breath test was conducted for *** *** The prevalence of *** infection was 46.5%(507/1090).The infection rate in men was 51.8%,which was significantly higher than that in women(42.5%;Pction rate in illiterate people was significantly higher than that in literate persons(53.5%vs 44.8%,Pction rate of *** gradually increased with age and the difference was statistically significant(Pction rate in smokers was significantly higher than that in non-smokers and those who had quit smoking(PcONcLUSION The prevalence of *** infection among elderly people is 46.5%and the infection rate gradually increases with ***,education level,age,and smoking were determined to be *** infection risk *** relationship of *** infection with region,occupation,drinking,and diet structure needs to be further studied.

关键词： Helicobacter pylori Epidemiologic Elderly persons 13c-urea breath test Prevalence characteristics

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