Prevalence of Helicobacter pylori in gastric cancer in a South-east Asian population by 14C-urea breath test

Backgound: Helicobacter pylori is believed to play an important role in the aetiology of gastric cancer. There is a great variability in seropositivity and histological frequency of H. pylori in gastric cancer. The present prospective study investigates the prevalence of H. pylori infection in gastric cancer patients using C-14-urea breath testing. Methods: Patients with endoscopic biopsy-proven gastric cancer were fasted for 6 h prior to ingesting 18.5 x 10(4) Bq of C-14-urea cocktail orally. Breath samples were collected after 20 min by asking them to blow into a hyamine solution and measurements were read in a scintillation counter. Results: Fifty out of 51 patients (98%) with gastric cancer were positive on the C-14-urea breath test compared to 29 patients (61%) who were positive on histology. There was no association between sex, age or tumour site, stage, differentiation, Lauren type and H. pylori status. The test was negative in one patient with cardial tumour in which histology of the resected specimen was also negative for the bacteria. Conclusions: Active H. pylori infection is highly prevalent in gastric cancer in a South-East Asian population. The C-14-urea breath test is a highly sensitive method for detecting the presence of H. pylori even in gastric adenocarcinoma irrespective of the stage.