Does anti-Helicobacter pylori immunohistochemical staining has a confirmative role in the definitive diagnosis of negative gastric biopsy samples stained with routine histological stains?

Abstract

Helicobacter pylori (H. pylori) causes chronic gastritis, and is associated with gastric lymphoma and carcinoma. Although severe infections with many bacteria can be identified easily on hematoxylin-eosin (H&E)–stained tissue samples; the identification ratio is only 66% with many false-positive and false-negative results. Furthermore, identification of the low-density bacteria, primarily following the therapy, requires special staining methods. The purpose of this study was to investigate whether the use of anti-helicobacter immunohistochemical (IHC) methods in the histopathological diagnosis of H. pylori is necessary to obtain accurate results. We investigated whether the use of specific immunohistochemical methods can detect H. pylori, which previously undetected by classical histological staining methods, in endoscopic gastric biopsy specimens. The study involved 210 endoscopic gastric biopsies considered as H. pylori negative with routine histological stainings and subsequently applied IHC staining methods to confirmative diagnosis. Inflammation was seen in all cases. One hundred thirty-eight patients had chronic inactive, 72 patients had chronic active gastritis. While H. pylori was found as negative in all cases with H&E and Giemsa stainings, in 60 of all these cases, H. pylori was found as positive with anti-H. pylori IHC staining. We suggest that in cases of chronic gastritis suggestive of H. pylori infection, when H. pylori cannot be seen by routine histological stainings, the IHC staining method is a definitive diagnostic tool for identification of H. pylori to avoid from false negative results. [Med-Science 2019; 8(4.000): 786-91]

Keywords

• gastritis
• helicobacter pylori
• immunohistochemistry