Original Research Article
Year: 2018 | Month: March | Volume: 8 | Issue: 3 | Pages: 39-47
Detection of Helicobacter Pylori in Gastric Biopsies of Patients with Chronic Gastritis: Histopathological and Immunohistochemical Study
Sunita Bamanikar1, Anushree Khandelwal2, Kushal Shah3, Arvind Bamanikar4, Archana Buch5
1,5Department of Pathology, 2,3Resident Pathologist,4Department of Medicine, Dr. D.Y.Patil Medical College, Hospital and Research Center, Dr. D.Y.Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India.
Corresponding Author: Sunita Bamanikar
Introduction: H. pylori infection is a major cause of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and gastric B-cell lymphoma (MALT lymphoma). Infection with this organism affects more than half the world’s population. Although, several special stains have been used to detect H. pylori in histological sections; however, their sensitivity and specificity vary greatly.
Aims and Objectives: This study was conducted to compare traditional staining methods with immunohistochemical method in diagnosing H. pylori in chronic gastritis.
Materials and Methods: This is a retrospective and prospective study, includes 985 gastric biopsies (471 retrospective and 514 prospective) with histopathological diagnosis of chronic gastritis. Slides were stained with Hematoxylin and eosin (H&E), modified Giemsa and immunohistochemical staining (IHC) was done using polyclonal antibody marker for H. Pylori. Sensitivity, specificity and positive predictive value of the H&E, Giemsa stains was calculated.
Results: Most of the biopsies were obtained from gastric antrum (895) by endoscopic method, followed by gastric body. Recurrent abdominal pain (92.79%) was the most frequently encountered clinical presentation. H. pylori was identified in 40.3% biopsies stained by H&E, followed by 49.2% of biopsies stained with modified Giemsa stain, the frequency of detection was greater with IHC stained sections 52.7%.
Conclusion: Although H & E and modified Giemsa stains, are standard stains for detection of H. pylori; the reliability and yield is better using IHC stains; especially when present even in coccoid forms or in small numbers.
Key words: H. Pylori, Immunohistochemistry, Special stains, chronic gastritis.