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Comparison Of Diagnostic Methods For H Pylori

Table 1 Comparison of diagnostic methods


Primary diagnosis

Diagnosis after therapy

Sensitivity;

Specificity

Costs

Advantages

Limitations

Non-invasive


13C-urea breath test

+++

+++

>95%;

>95%

$$

Reliable, simple,  widely available, rapid

No

Monoclonal stool antigen

+++

+++

>95%;

>95%

$

Reliable, simple, rapid

Patient Reluctance

IgG serology

(+)

-

75-85%;

79-90%

$

Widely available, identifies virulence   factors

Remains positive after eradication, low   sensitivity

Invasive by Endoscope


Histology

++

++

60-86%;

>98%

$$$

Good sensitivity,

secondary diagnostic

information

High inter-observer variability, time-consuming

Immunohisto-chemistry

(+)

(+)

>97%;

100

$$$$

Excellent sensitivity,

secondary diagnostic

information

Expensive, time-consuming

Rapid urease test

+++

(+)

80–95 %;

97–99 %

$$$

Cheaper, simple, rapid

Requires high bacterial burden

Culture

-

+

60%;

100%

$$$$

Antibiotic sensitivity profile

Limited availability, slow, technically   challenging

PCR

(+++)

(+++)

Up to 100%; Up to 100%

$$$$

Quick, antibiotic sensitivity profiling

Expensive, limited availability,   contamination, presence of polymerase inhibitors



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