13C-Urea Breath Test for the Diagnosis of H. pylori Infection in Patients after Partial Gastrectomy: A Systematic Review and Meta-Analysis

Abstract

Background

The ¹³C-urea breath test (¹³C-UBT) is a kind of safe, noninvasive, and reliable measure for Helicobacter pylori (H. pylori) infection diagnosis in patients with complete stomach. Nevertheless, the test has not indicated fully precision in people who have had a gastrectomy. So, we made the use of a systematic review of plentiful published resources and research and meta-analysis. There are prominent research achievements regarding of utilizing ¹³C-UBT for H. pylori infection patients diagnosis with the residual stomach.

Method

We searched publications available on Cochrane, PubMed, and Embase databases, and on the web of science. The last search was performed in May 2021. The basis model for this meta-analysis was fixed-effect through Metadisc Beta 1.4 software (Universidad Complutense, Madrid, Spain). When measuring the precision of ¹³C-urea breath test, we utilized the ratio analysis such as Ratio of diagnostic odds ratio (DOR) and its corresponding 95% confidence interval (95%CI).

Results

Ten associated researches were analyzed with a total of 1065 patients. In general, the sensitivity of included studies ranged from 0.40 to 1.00 (I² = 81.2%), whereas the specificity ranged from 0.59 to 1.00 (I² = 90.1%). The pooled sensitivity, specificity were 0.83 (95% CI, 0.79–0.86; P < 0.001), 0.79 (95% CI, 0.76–0.83; P < 0.001) respectively. The accuracy ranged from 71 to 99. The positive predictive values ranged from 45 to 100. The negative predictive values ranged from 53 to 100. The combined DOR was 36.02 (95%CI 15.65–82.92; I² = 65.8%; P = 0.0018). The corresponding AUC for the SROC curve was 0.92 and the Q value was 0.85.

Conclusion

In conclusion, the outcomes of meta-analysis indicate that during the period of patients’ diagnosis in H. pylori infection, who undergoes partial gastrectomy, has high accuracy.

Keywords:

• ¹³C-urea breath test
• H. pylori
• gastroenterology
• meta-analysis
• gastrectomy

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Domestic support from (1) National Natural Science Foundation of China (No. 81772547); (2) the Fundamental Research Funds for the central Universities (No. 2017SCU04A18); (3) Young scientific and academic leaders training program of Sichuan University (No. 0082604151001/035); (4) Foundation of Science & Technology Department of Sichuan Province (No. 2019YFS0256); (5) 1. 3. 5 project for disciplines of excellence, West China Hospital, Sichuan University (No. ZY2017304).