Selective staining of gastric biopsies for H. pylori does not affect detection rates or turnaround time and improves cost compared to reflexive staining

Decker, Lauren A.; Routh, Joshua Keith; Snider, Jessica S.; Hanson, Joshua A.

doi:10.1016/j.prp.2016.09.003

Cited by 32 publications

(2 citation statements)

References 17 publications

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“…Our results confirm the current guidelines and supportive studies that ancillary stains should not be routinely ordered upfront 5,8,9,22. In addition, we identified 4 cases (6.1%) in which the H&E-stained sections and immunohistochemical stains were negative, but the patients were regarded as having a true infection, given the clinical history and additional laboratory testing results.…”

Section: Discussionsupporting

confidence: 87%

“…Our results confirm the current guidelines and supportive studies that ancillary stains should not be routinely ordered upfront. 5,8,9,22 In addition, we identified 4 cases (6.1%) in which the H&E-stained sections and immunohistochemical stains were negative, but the patients were regarded as having a true infection, given the clinical history and additional laboratory testing results. This supports the recommendations from Panarelli et al 10 that the failure to identify bacteria on near-normal gastric biopsies generally reflects their absence, thus reducing the diagnostic utility of ancillary stains in these scenarios.…”

Section: Discussionmentioning

confidence: 99%

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Objective Visual Analog Scale for Biopsy Diagnosis of Helicobacter pylori Infection in Clinical Practice

Boylan

Patrey

McMullen

et al. 2021

American Journal of Surgical Pathology

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Historic and current pathology society guidelines recommend using visual gestalt to identify substantial inflammatory cell infiltrate in Helicobacter pylori gastritis, but these scales were subjectively designed. This study aims to objectively investigate the density of inflammation that justifies additional workup for H. pylori infection. We retrospectively identified 2 patient cohorts who had undergone endoscopy with gastric biopsies; 1 with H. pylori infection (n=66), confirmed with a positive stool antigen test and/or Campylobacter-like organism test, and 1 without infection (n=81). Antral and body biopsies were selected from each case, if available, and stained with MUM-1 to highlight mucosal plasma cells. Digital analysis was performed to calculate the number of plasma cells/mm2, termed the “inflammatory score” (IS). Patients with H. pylori infection had an average of 1289 plasma cells/mm2 in the antrum and 835 plasma cells/mm2 in the body, compared with 346 plasma cells/mm2 in the antrum and 178 plasma cells/mm2 in the body in patients without infection. IS cut-off values for a positive infection were 714 plasma cells/mm2 in the antrum and 316 plasma cells/mm2 in the body, with high sensitivities and specificities in both the antrum (92%, 92%) and body (85%, 84%), respectively. A visual analog scale was created to provide a histologic correlate of the observed IS ranges and cut-offs. This practical and objective scale is associated with a high sensitivity and specificity for diagnosing H. pylori infection and justifies moving away from upfront universal H. pylori testing in routine clinical practice.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Objective Visual Analog Scale for Biopsy Diagnosis of Helicobacter pylori Infection in Clinical Practice

Boylan

Patrey

McMullen

et al. 2021

American Journal of Surgical Pathology

View full text Add to dashboard Cite

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Diagnostic d’infection à Helicobacter pylori sur biopsies gastriques : coloration standard, coloration spéciale ou immunohistochimie ?

Benoit

Hoyeau

Fléjou

2018

Annales de Pathologie

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Non-Neoplastic Pathology of the Gastrointestinal Tract

2020

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This book concisely summarises non-neoplastic gastrointestinal (GI) pathology and provides histopathologists aiming to refresh or expand their knowledge with a practical approach to the interpretation of biopsies. It focuses on GI biopsies, but also covers the pathology of resections and other organs where appropriate. The editor and contributors bring their expertise as practicing diagnostic pathologists across Europe and the US. Examples of topics include inflammatory bowel disease, infections, vascular disorders, and inflammatory conditions specific to various anatomical sites. Fact sheets, practice points and tables facilitate rapid assimilation of information and enhance the reader's experience, and with additional access to the full online version, including expandable images on Cambridge Core, achieve accuracy every time. High-quality illustrations are also numerous, and references are relevant and reliable. This book is a practical, readable and up-to-date asset for any pathologist encountering GI biopsies.

show abstract

Selective staining of gastric biopsies for H. pylori does not affect detection rates or turnaround time and improves cost compared to reflexive staining

Cited by 32 publications

References 17 publications

Objective Visual Analog Scale for Biopsy Diagnosis of Helicobacter pylori Infection in Clinical Practice

Objective Visual Analog Scale for Biopsy Diagnosis of Helicobacter pylori Infection in Clinical Practice

Diagnostic d’infection à Helicobacter pylori sur biopsies gastriques : coloration standard, coloration spéciale ou immunohistochimie ?

Non-Neoplastic Pathology of the Gastrointestinal Tract

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