Histological Identification of Helicobacter pylori: Comparison of staining methods

  • Dr Pranjal Sharma R MBBS Student, M.S. Ramaiah Medical College, MSR College Road, MSR Nagar, MSRIT Post, Mathikere, Bengaluru, Karnataka 560054, India
  • Dr. Kalpana Kumari MK Associate Professor, Dept. of pathology, M.S. Ramaiah Medical College, MSR College Road, MSR Nagar, MSRIT Post, Mathikere, Bengaluru, Karnataka 560054, India
Keywords: Gastritis, Haematoxylin & Eosin, Helicobacter Pylori, Special Staining

Abstract

Background: Helicobacter pylori has a high incidence world over and especially in developing countries. It causes many histological derangements apart from causing chronic gastritis.

Objectives: The study was done to compare Haematoxylin & Eosin (H&E) and Giemsa with Immunohistochemistry (IHC) for the detection of Helicobacter pylori and to correlate the H. pylori positivity with histological changes.

Methods: This was a cross sectional study done, in Department of Pathology, on gastric biopsies, with clinical suspicion of Helicobacter pylori infection, received in the period between Jan 13- Dec 13. Sections were stained with H&E, Giemsa and IHC. Along with detection of the organism associated morphological changes were assessed. The stains were validated using IHC as gold standard.

Results: A total of 58 samples were evaluated. Fourteen (24.1%) samples showed positivity with IHC, of which 11(19%) and 9(15.5%) were positive with H&E and Giemsa respectively. H&E had a high false positive rate (19%). Giemsa staining showed less sensitivity (64.28%) compared to H&E (78.57%). Morphological changes were assessed and organisms were noted in 14(25.5%) cases with inflammation, 8(30.8%) cases with activity and 2(28.6%) cases with atrophy. No organisms were seen associated with intestinal metaplasia.

Conclusion: Giemsa was not found to be superior to H&E in detecting Helicobacter pylori. Use of IHC not only reduces rate of false positive results, but also diagnosis of any mild infection that is not detected on H&E can be made.

Downloads

Download data is not yet available.

References

1. Yantiss RK, Lamps LW. To stain or not to stain...That remains the question. Am J Clin Pathol 2012; 137(3):343-5.

2. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 2006; 19: 449-490.

3. Tajalli R, Nobakht M, Mohammadi-Barzelighi H, Agah S, Rastegar-Lari A, Sadeghipour A. The immunohistochemistry and toluidine blue roles for Helicobacter pylori detection in Iran patients with gastritis. Anti-Microbial Resistance Research Center, Tehran University of Medical Sciences, Tehran, Iran. Biomed J. 2013; 17(1): 36–41.

4. Garza-González E et al. Diagnosis and treatment of H. pylori infection. World J Gastroenterol 2014; 20(6): 1438-1449.

5. Toulaymat M, Marconi S, Garb J, Otis C, Nash S. Endoscopic Biopsy Pathology of Helicobacter pylori Gastritis Comparison of Bacterial Detection by Immunohistochemistry and Genta Stain. Arch Pathol Lab Med. 1999; 123:778–781.

6. Shukla S, Pujani M, Rohtagi A. Correlation of Serology with Morphological Changes in Gastric Biopsy in Helicobacter Pylori Infection and Evaluation of Immunohistochemistry for H. Pylori Identification. Saudi J Gastroenterol. 2012; 18(6): 369–374.

7. Tonkic A, Tonkic M, Lehours P, Mégraud F. Epidemiology and diagnosis of Helicobacter pylori infection. Helicobacter 2012; 17: 1-8.

8. Chey WD, Wong BCY. American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection. Am J Gastroenterol.2007; 102(8):1808-25.

9. H R Wabinga. Comparison of immunohistochemical and modified Giemsa stains for demonstration of Helicobacter pylori infection in an African population. African Health Sciences 2002; 2(2):52-55.

10. Rotimi O, Cairns A, Gray S, Moayyedi P, Dixon MF. Histological identification of Helicobacter pylori: comparison of staining methods. J Clin Pathol. 2000;53:756–759.

11. Hartman DJ, Owens SR. Are routine ancillary stains required to diagnose Helicobacter infection in Gastric biopsy specimens – an institutional quality assurance review? Am J. Clin Pathol. 2012. 137:255-260

12. Wang XI, Zhang S, Abreo F et al. The role of routine immunohistochemistry for Helicobacter pylori in gastric biopsy. Ann Diagn Pathol. 2010; 14:256-259.

13. Intisar S, Pity Azad M, Baizeed. Identification of Helicobacter Pylori in Gastric Biopsies of Patients with Chronic Gastritis: Histopathological And Immunohistochemical Study. Duhok Med J 2011; 5(1): 69-77.

14. Dixon MF, Genta RM, Yardley JH, Correa P and the Participants in the International Workshop on the Histopathology of Gastritis, Classification and Grading of Gastritis. The updated Sydney System. Am J Surg Pathol 1996;20:1161-81.

15. Laine L, Lewin DN, Naritoku W, et al. Prospective comparison of H&E, Giemsa, and Genta stains for the diagnosis of Helicobacter pylori. Gastrointest Endosc 1997;45:463-7.

16. Stolte M, Stadelmann O, Bethke B, Burkard G. Relationships between the degree of Helicobacter pylori colonization and the degree of activity of gastritis, surface epithelial degeneration and mucus secretion. Z Gastroenterol. 1995;33:89–93.

17. Miehlke S, Hackelsberger A, Meining A, Hatz R, Lehn N, Malfertheiner P, Stolte M, Bayerdörffer E. Severe expression of corpus gastritis is characteristic in gastric cancer patients infected with Helicobacter pylori. Br J Cancer. 1998;78:263–266.

18. Zhang C, Yamada N, Wu YL, Wen M, Matsuhisa T, Matsukura N. Helicobacter pylori infection, glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer. World J Gastroenterol. 2005;11:791–6.

19. Aydin O, Egilmez R, Karabacak T, Kanik A. Interobserver variation in histopathological assessment of Helicobacter pylori gastritis. World J Gastroenterol 2003; 9(10):2232-2235
CITATION
DOI: 10.17511/ijmrr.2015.i10.211
Published: 2015-11-30
How to Cite
1.
Sharma R P, Kumari MK K. Histological Identification of Helicobacter pylori: Comparison of staining methods. Int J Med Res Rev [Internet]. 2015Nov.30 [cited 2024Mar.28];3(10):1167-73. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/386
Section
Original Article