{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:18:45Z","timestamp":1787635125500,"version":"build-2736575974"},"reference-count":55,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Helicobacter pylori<\/jats:italic>\n                      is a major cause of gastric carcinogenesis, and accurate detection of active infection guides eradication therapy and cancer prevention. The urea [\n                      <jats:sup>14<\/jats:sup>\n                      C] breath test (UBT) is widely used, but its reliability and optimal timing when performed on the same day after gastroscopy are uncertain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this single-center retrospective diagnostic-accuracy study, 298 adults underwent gastroscopy followed by UBT at 1 hour (\n                      <jats:italic>n<\/jats:italic>\n                      = 99), 2 hours (\n                      <jats:italic>n<\/jats:italic>\n                      = 99), or 4 hours (\n                      <jats:italic>n<\/jats:italic>\n                      = 100) between December 2023 and January 2025. The reference standard was defined independently of the UBT as positive immunohistochemistry, or concordant rapid urease test and methylene blue staining in immunohistochemistry-negative cases. Agreement and diagnostic-performance measures were estimated, and histopathological characteristics of false-negative results were examined.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The reference-standard prevalence of\n                      <jats:italic>H. pylori<\/jats:italic>\n                      infection was 47.0% (140\/298). Agreement was substantial to almost perfect at 1, 2, and 4 hours (\u03ba = 0.758, 0.817, and 0.704, respectively; all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). The 2-hour interval had the highest specificity (96.2%) and positive predictive value (95.2%), whereas the 4-hour interval had the highest sensitivity (95.6%) and negative predictive value (95.5%). All five false-negative results at 1 hour occurred in histopathological Stage III (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.044). The examined procedural and mucosal-background factors were not significantly associated with UBT accuracy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Same-day post-gastroscopy UBT was clinically informative in this cohort. Among the evaluated intervals, 2 hours favored diagnostic confirmation, whereas 4 hours favored sensitivity-oriented screening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1935940","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T04:23:27Z","timestamp":1787631807000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Optimal post-gastroscopy timing of the urea [14C] breath test for Helicobacter pylori diagnosis: a histopathology-anchored diagnostic accuracy study"],"prefix":"10.3389","volume":"13","author":[{"given":"Mei","family":"Wu","sequence":"first","affiliation":[{"name":"School of Clinical Medicine, Guizhou Medical University","place":["Guiyang, Guizhou, China"]},{"name":"Department of Gastroenterology (Endoscopy Center), Zhejiang Provincial People's Hospital Bijie Hospital","place":["Bijie, Guizhou, 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