Title: Role of Special Stain Giemsa in Demonstration of Helicobacter Pylori in Gastric Biopsies
Authors: Dr Ruby Elizabeth Elias, Dr Bindiya Gisuthan, Dr Deepthi Raj M.L
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.83
Abstract
Introduction: Helicobacter pylori is a gram negative, curved bacillus, found in the gastric mucosa which was recognized as a Class I carcinogen. Majority of gastric adenocarcinomas and most gastric MALT lymphomas are related to chronic infection with this organism. Various invasive and noninvasive methods are available for the identification of H.pylori. The gold standard for the diagnosis remains to be histopathology and culture. But culture is a laborious and time consuming method. Histopathological identification of H.pylori can be improved with the use of special stains like Giemsa. The aim of this study was to evaluate the efficacy of the special stain (Giemsa) in the identification of H.pylori compared to the routine H &E stain (Hematoxylin and Eosin).
Materials and Methods: Gastric biopsies taken from dyspeptic patients were evaluated with routine H&E and Giemsa stains. The presence of H.pylori was analysed in both the groups.
Results: Out of 150 cases studied Giemsa stain revealed H.pylori in 58.67% of cases whereas routine H & E stain identified only 44.67% of cases. This was found to be statistically significant.
Discussion and Conclusion: Special stain like Giemsa should definitely be used as an adjunct to standard H &E stain for the identification of H.pylori in gastric biopsies. The depiction of H.pylori in gastric biopsies allows for the specific treatment by which the eradication of the organism can be done, thereby decreasing the incidence of gastric carcinoma and MALT Lymphoma.
Keywords: Giemsa, Gastritis, Hematoxylin and Eosin stain.
References
- MarshallBJ,WarrenJR.Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration.Lancet.1984 Jun 16;1(8390):1311-5
- Selvi Thirumurthi ,David Y. Graham. Helicobacter pylori infection in India from a western perspective. Indian J Med Res. 2012 Oct; 136(4): 549–562
- Singh V, Trikha B, Nain CK, Singh K, Vaiphei K. Epidemiology of Helicobacter pylori and peptic ulcer in India. J GastroenterolHepatol. 2002;17:659–65
- Cha MS. Comparative analysis of histochemical stains about detection of H. pylori in gastric mucosa. Korean J Clin Lab Sci 2007;39:223-30.
- Kodama M, Murakami K, Okimoto T, Fukuda Y, Shimoyama T, Okuda M, Kato C, Kobayashi I, Fujioka T. Influence of proton pump inhibitor treatment on Helicobacter pylori stool antigen test.World J Gastroenterol. 2012 Jan 7;18(1):44-48
- Tseng CA, Wang WM, Wu DC. Comparison of the clinical feasibility of three rapid urease tests in the diagnosis of Helicobacter pylori infection. Dig Dis Sci 2005;50:449-52.
- Hirschl AM, Makristathis A. Methods to detect Helicobacter pylori: from culture to molecular biology. Helicobacter 2007;12:6-11.
- Mitsushige Sugimoto, Jeng-Yih Wu, Suhaib Abudayyeh, Jill Hoffman, Hajer Brahem, Khaldun Al-Khatib, Yoshio Yamaoka, David Y. Graham. Unreliability of Results of PCR Detection of Helicob-acter pylori in Clinical or Environmental Samples J. Clin. Microbiol. March 2009;47(3): 738- 40
- Ramis IB, de Moraes EP, Fernandes MS, et al. Evaluation of diagnostic methods for the detection of Helicobacter pylori in gastric biopsy specimens of dyspeptic patients. Braz J Microbiol 2012;43:903-8.
- Marcela S. Boldt, Rivelle D. Pereira, Alfredo J. A,Barbosa. Histological identification of H. pylori stained by hematoxylin-eosin and Giemsa:review for quality control. J Bras Patol Med Lab.2015April ;51( 2) :108-112
- Hartman DJ, Owens SR. Are routine ancillary stains required to diagnose Helicobacter infection in gastric biopsy specimens? An institutional quality assurance review. American journal of clinical pathology. 2012Feb; 137(2): 255-60.
- S Adlekha, T Chadha, P Krishnan, B Sumangala .Prevalence of Helicobacter Pylori Infection Among Patients Undergoing Upper Gastrointestinal Endoscopy in a Medical College Hospital in Kerala, India.Ann Med Health Sci Res. 2013 Oct-Dec; 3(4): 559–563
- Laine L, Lewin DN, Naritoku W, et al. Prospective comparison of H&E, Giemsa, and Genta stains for the diagnosis of Helicobacter pylori. GastrointestEndosc 1997;45:463-7.