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Gastroenterology Research and Practice
Volume 2011, Article ID 235796, 6 pages
Research Article

Diagnostic Value of the 13C Methacetin Breath Test in Various Stages of Chronic Liver Disease

1Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia, 56000 Kuala Lumpur, Malaysia
2Division of Gastroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
3Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, 56000 Kuala Lumpur, Malaysia
4Sentosa Kajang Medical Centre, 43000 Kajang, Selangor, Malaysia

Received 15 February 2011; Revised 23 March 2011; Accepted 9 April 2011

Academic Editor: Edoardo G. Giannini

Copyright © 2011 Hamizah Razlan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The accuracy of the 13C-methacetin breath test (13C-MBT) in differentiating between various stages of liver disease is not clear. A cross-sectional study of Asian patients was conducted to examine the predictive value of the 13C-MBT in various stages of chronic liver diseases. Diagnostic accuracy of the breath test was determined by sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve analysis. Seventy-seven patients (47 men/30 women, mean age years) were recruited. Forty-seven patients had liver cirrhosis (Child Pugh A = 11, Child Pugh B = 15, and Child Pugh C = 21), 21 had fibrosis, and 9 had chronic inflammation. The sensitivity and positive predictive value for liver fibrosis, cirrhosis (all stages), Child-Pugh A, Child-Pugh B, and Child-Pugh C were 65% and 56%, 89% and 89%, 67% and 42%, 40% and 40%, and 50% and 77%, respectively. Area under curve values for fibrosis was 0.62 (0.39–0.86), whilst that for cirrhosis (all stages) was 0.95 (0.91–0.99). The 13C-methacetin breath test has a poor predictive value for liver fibrosis but accurately determines advanced cirrhosis.