Comparison between phenol red chromo-endoscopy and a stool rapid immunoassay for the diagnosis of Helicobacter pylori in patients with gastritis

Warthin-Starry Staining for the Detection of Helicobacter pylori in Gastric Biopsies

Background

Warthin-Starry (WS) staining is an ancillary stain used in the detection of Helicobacter sp., spirochaete and other microorganisms in tissue sections. The present study aimed to determine the validity of WS stain in the confirmation of H. pylori diagnosis in gastric biopsies in comparison with anti-H. pylori immunohistochemistry (IHC) staining.

Methods

This study involved 104 cases of gastric biopsies that were previously subjected to WS staining. All cases involved retrieval of formalin-fixed paraffin-embedded (FFPE) gastric biopsies that were re-cut, subjected to anti-H. pylori IHC staining and reviewed blindly by a pathologist. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of WS as compared to IHC were calculated.

Results

In this study, WS stain was less sensitive in detecting H. pylori. The sensitivity, specificity, PPV and NPV for WS stain were 50.0%, 92.4%, 79.2% and 76.3%, respectively.

Conclusions

The sensitivity of WS stain in the histopathology laboratory was lower than that described previously. Several external factors that might influence the results were identified. However, sufficient information on patients’ history of treatment and medication would be required for the diagnosis or confirmation of the presence of H. pylori in gastric biopsies by WS staining.