|
| Diagnostic test | Sensitivity
[18, 21] | Specificity
[18, 21] | Advantages | Disadvantages |
|
| Direct test | | | | |
| Histology | 95% | 99% | High accuracy, a possibility to send specimens at room temperature, and combination with IHC increase accuracy. | Low sensitivity for patients with gastric atrophy or intestinal metaplasia, time and cost, dependent on the operator skills, and interobserver variability. |
| Culture | 69–98% | 100% | Direct detection of H. pylori, excellent specificity, and allowing determination of antibiotic sensitivities. | Limited sensitivity, time-consuming procedure, and need of a special transport. |
| RUT | 90% | 93% | Inexpensive and provides rapid results, adding the number and increasing the size of biopsy specimens will increase the accuracy. | Sensitivity significantly reduced by bismuth, PPI and antibiotics, and formalin contamination of biopsy forceps generate false negative. |
|
| Indirect test | | | | |
| UBT | 95% | 95% | Higher accuracy than serology and SAT, having a new portable type. | Atrophy, bismuth, PPI and antibiotics induce false-negative and need a local validation. |
| SAT | 94% | 92% | More economical than UBT and monoclonal antibody showed better accuracy. | Differences in the antigens may affect the accuracy, influence by bismuth, PPI, and antibiotics, and accuracy was influenced by stool condition. |
| Serology | 90% | 80% | Inexpensive, widely available, and the most efficient method in particular condition. | Less accurate than UBT and SAT and the cut-off values should be validated locally and cannot distinguish between current and past infections. |
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