Diagnosis of Helicobacter pylori in gastric brush and biopsy specimens stained by Rowmanowsky and immunocytochemical methods: comparison with the CLOtest

Abstract

Helicobacter pylori has been implicated in the pathogenesis of chronic gastritis, gastric and duodenal ulcer, and possibly gastric carcinoma. The organism may be detected by invasive or non-invasive methods with variable sensitivity. Paired gastric biopsy and gastric brush specimens were collected from 83 patients presenting with non-ulcer dyspepsia. One biopsy was tested for urease using the CLOtest, the other was processed to paraffin and consecutive sections were stained with haematoxylin and eosin, modified Giemsa and anti-H. pylori antisera. The brush specimens were stained with a rapid Romanowsky stain (Hema-Gurr) and anti-H. pylori. The CLOtest was positive in 31 cases, the Giemsa biopsy in 25, the anti-H. pylori biopsy in 27, the Hema-Gurr smear in 27 and the anti-H. pylori smear in 19. The sensitivities of the methods after omitting one inadequate biopsy were 96%, 93%, 100%, 96% and 78%, respectively. The specificities were 93% for the CLOtest and 100% for the other methods. While immunocytochemical staining of gastric biopsies may be the most sensitive method for H. pylori identification, the cost and turn around time of the technique may preclude its routine use. Gastric brush cytology is a highly sensitive and specific method for H. pylori detection that is quick and simple to perform. Its application is recommended for the routine diagnosis of H. pylori infection.

Imprint Cytology in the Diagnosis of <i>Helicobacter pylori</i>

“…2,5 When treatment of H pylori infection is considered, a reliable diagnosis is essential. 1,6 Diagnostic techniques can be divided into invasive and noninvasive methods.…”

“…The biopsy specimens are studied for the presence of H pylori using culture, rapid urease test (e.g., CLO test) and various histologic staining techniques. 2,[5][6][7][8] Noninvasive tests do not require endoscopy. They are tests that investigate the presence of antibodies against H pylori in the patients' sera and breath test samples with 13 C-or 14 C-labelled urea.…”

A Study to Detect Helicobacter Pylori in Adenotonsillar Tissue

“…9 In an investigation by Faraker, the sensitivity and specifi city of immunostaining gastric brush smears were 78 and 100%, respectively. 10 Similarly, Tokunaga et al reported that Giemsa staining was 91% sensitive and 100% specifi c. 11 Kassa and colleagues found that Gram staining may be less sensitive than immunostaining or Giemsa staining. 12 Morinaka et al reported that the Campylobacter-like organism (CLO) test detects urease activity and thus indicates the presence of viable ureaseproducing organisms, but that a fi nding of positivity or negativity depends on the concentration of H pylori.…”

Feasibility Study of Using Breath Ammonia Analysis Based on Off-Axis Cavity-Enhanced Absorption Spectroscopy with External Cavity Diode Laser for Noninvasive Real-Time Diagnosis of Helicobacter Pylori

“…1 In 1983, the relationship between HP and both peptic ulcers and gastric cancer was first proposed by Warren and Marshall. 2 Multiple tests are available for detecting HP infection: the blood antibody test (BAT), 3 the stool antigen test (SAT), 4 stomach biopsy, 5 and the urea breath test (UBT). 6 The BAT is an invasive method because a needle is inserted to draw blood.…”