Evaluation of Better Staining Method among Hematoxylin and Eosin, Giemsa and Periodic Acid Schiff-Alcian Blue for the Detection of Helicobacter pylori in Gastric Biopsies

Abstract

Background: This study was undertaken to evaluate the preferred method (Giemsa or periodic acid Schiff-Alcian blue [PAS-AB] stains) of detecting Helicobacter pylori (H. pylori) in gastric mucosal biopsies in terms of sensitivity, specificity and applicability. To the best of my knowledge, this is the first report comparing Giemsa and PAS-AB staining for the detection of H. pylori in such biopsies. Methods: The formalin-fixed paraffin-embedded blocks of 49 gastric biopsies from different patients were collected from the archive of anatomical pathology at King Abdulaziz Medical City, National Guard, Riyadh, Saudi Arabia. From each block, three slides were prepared and analysed using the hematoxylin and eosin (H&E), Giemsa and PAS-AB stains to detect the presence/absence of H. pylori, and the results were compared in terms of sensitivity, specificity and applicability. Results: The majority of the biopsies in this study showed antrum-type gastric mucosa. Only 15 biopsies showed active gastritis, whereas the rest showed chronic gastritis. Three biopsies showed intestinal metaplasia. All were detected by PAS-AB stain, but only two-thirds were detected by H&E stain. Fifteen gastric biopsies showed H. pylori infection in general and in 13 of them, active gastritis cases were discovered. Fourteen out of these 15 H. pylori infection cases were detected by Giemsa stain, whereas only 13 cases were detected by H&E stain. PAS-AB stain showed the worst results since it demonstrated only 40% sensitivity and 67.65% specificity in H. pylori detection. Conclusion: Giemsa stain has better sensitivity and specificity in gastric H. pylori infection detection than PAS-AB. Therefore, using PAS-AB stain to detect H. pylori infection is not recommended.

Comparative Study of Modified Silver Nitrate Staining for the Detection of Helicobacter pylori

“…Therefore, an effective method for detecting Hp in clinical practice is important for the prevention and control of gastrointestinal diseases that it causes. Clinical methods for the detection of Hp infection are classified as invasive and noninvasive 5,9. Different detection methods employ different principles, are suitable for different populations, and have their own advantages and disadvantages.…”

“…Clinical methods for the detection of Hp infection are classified as invasive and noninvasive. 5 , 9 Different detection methods employ different principles, are suitable for different populations, and have their own advantages and disadvantages. The urea 14 C-UBT non-invasive method is considered effective for diagnosing Hp infection without culture.…”

“…Therefore, a rapid and effective Hp detection method is important. At present, various types of biopsy-based methods are used for Hp testing, and the gold standard for diagnosing Hp infection is histology or a combination of histology and culture 5. In recent years, most hospitals in China have used various histochemical and immunohistochemical staining methods for Hp detection, but the sensitivity and specificity of Hp tests vary.…”

“…At present, various types of biopsy-based methods are used for Hp testing, and the gold standard for diagnosing Hp infection is histology or a combination of histology and culture. 5 In recent years, most hospitals in China have used various histochemical and immunohistochemical staining methods for Hp detection, but the sensitivity and specificity of Hp tests vary. Different methods have their own advantages and disadvantages, but the reproducibility of the test results is often poor.…”

A Retrospective Experience of Helicobacter pylori Histology in a Large Sample of Subjects in Northern Italy

“…H. pylori was searched for in all patients with gastric biopsies using the Giemsa stain. The sensitivity of the Giemsa stain for the detection of H. pylori is about 93%, while its specificity is about 100% [ 9 ]. Proton pump inhibitors (PPI) are stopped at least two weeks before gastroscopy (this is to improve the accuracy of H. pylori detection in patients undergoing biopsies in the antrum only [ 10 ])…”