Comparison of various histochemical staining methods for identification of helicobacter pylori

Kanimozhi Gowsik, Archana V


Introduction: Helicobacter pylori infection plays a key role in the development of gastritis, Gastric ulcer and Gastric malignancy. More than half the world’s population is infected with this organism. The infection is more common in developing countries due to poor sanitation, overcrowding and low economic status. In view of this pathogenetic importance, diagnosis of H. Pylori is very important to institute eradication treatment. Various techniques are available for the detection of H. Pylori including serology, rapid urease test,13C-breath test, antigen detection in stool, histological examination and IHC. Aim: This study was conducted to compare various histochemical staining methods for identification of helicobacter pylori in endoscopic biopsy taken for gastritis. Materials and Methods: A total of 68 cases were included in this study over a period of six months. Slides were stained with 5 different histochemical stains. Sensitivity, Specificity and positive predictive value was calculated. As per literature modified giemsa was considered as standard and the findings from other stains were compared with it. Results: Out of 68 cases of gastric biopsy diagnosed of gastritis, 23 cases were positive for H. Pylori with Modified Giemsa, 17 with H&E, 23 with Toluidine blue, 21 with Acridine orange, 14 with Alcian blue. Conclusion: Histopathological examination is the gold standard method for identification. whichever stains used careful examination for the organism is essential. All the staining methods were easy to perform and cheap. Modified Giemsa, H&E and Acridine orange are more reliable.

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World gastroenterology organization global guideline: Helicobacter pylori in developing countries. J Dig Dis 2011;12(5):319-326. doi: 10.1111/j.1751-2980.2011.00529. x.

Mills AS, Contos MJ. The Stomach. In: Silverberg SG (ed). Silverberg's Principles and Practice of Surgical Pathology and Cytopathology. 4th edition. Churchill Livingstone, 2005;1321-1372.

Marshall B. Helicobacter pylori--a Nobel pursuit? Can J Gastroenterol. 2008;22(11):895-896. doi:10. 1155/ 2008/459810

Rosai J, Chapter 11. Gastrointestinal tract. Rosai and Ackerman’s Surgical Pathology, 9th ed. Elsevier, Mosby.2004;1:615-871.

Fenoglio-Preiser C, Carneiro F, Correa P, Guilford P, Lambert R, Megraud F, et al. Gastric carcinoma. Pathology and genetics of tumours of the digestive system. World Health Organization Classification of Tumors.2000;1:35-52.

Rotimi O, Cairns A, Gray S, Moayyedi P, Dixon MF. Histological identification of Helicobacter pylori: comparison of staining methods. J Clin Pathol. 2000;53(10):756-759. doi: 10.1136/jcp.53.10.756

Yakoob J, Jafri W, Abid S, Jafri N, Abbas Z, Hamid S, et al. Role of rapid urease test and histopathology in the diagnosis of Helicobacter pylori infection in a developing country. BMC Gastroenterol. 2005; 5:38. doi: 10.1186/1471-230X-5-38

Mesher AL. Junqueira's Basic Histology. Chapter 15. Digestive Tract. 12th ed. The McGraw-Hill Companies. 2010; 312-346.

Loffeld RJ, Stobberingh E, Arends JW. A review of diagnostic techniques for Helicobacter pylori infection. Digestive Diseases. 1993;11(3):173-180.

Haqqani MT, Langdale-Brown B. Campylobacter pylori--acridine orange stain and ultraviolet fluorescence. Histopathol. 1988;12(4):456-457. doi: 10.1111/j.1365-2559. 1988.tb01964.x

Sandra Wilkins, AS, HT(ASCP) Helicobacter pylori, Michigan Institute of Urology.

Kaur G, Madhavan M, Basri AH, Sain AH, Hussain MS, Yatiban MK, Naing NN. Rapid diagnosis of Helicobacter pylori infection in gastric imprint smears. Southeast Asian J Trop Med Public Health. 2004;35(3):676-680.

Graham DY. Campylobacter pylori and peptic ulcer disease. Gastroenterol. 1989;96(2 Pt 2 Suppl):615-625. doi: 10.1016/s0016-5085(89)80057-5.

Misra V, Misra SP, Dwivedi M, Gupta SC. The Loeffler's methylene blue stain: an inexpensive and rapid method for detection of Helicobacter pylori. J Gastroenterol Hepatol. 1994;9(5):512-513. doi: 10.1111/j.1440-1746. 1994.tb01283.x

Ahluwalia C, Jain M, Mehta G, Kumar N. Comparison of endoscopic brush cytology with biopsy for detection of Helicobacter pylori in patients with gastroduodenal diseases. Indian J Pathol Microbiol. 2001;44(3):283-288.


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