• Oussama Belkacem Pathology



Helicobacter pylori, intestinal metaplasia, gastritis, special stain.


Problem: Special stains such as the Giemsa, the Alcian blue (AB) and the Periodic Acid Schiff (PAS) are widely used for gastric and/or esophageal biopsies for the diagnosis of Helicobacter pylori (H. pylori) and intestinal metaplasia (IM). The purpose of our study was to determine if these stains are actually needful

Methods: We retrospectively studied 209 gastric and esophageal biopsies. We evaluated the H. pylori status on hematoxylin and eosin (H&E) stained slides and the presence of IM and finally we examined the special stains.

Results: 23% of cases were H. pylori-positive. H&E stain had a high degree of accuracy (92,1%). The Giemsa stain was positive in 23,7% and negative in 71,8%. The Giemsa was useful in 16,7% biopsies. The AB revealed goblet cells in 4,8% cases. AB sensibility was 90,9%. From the 208 slides stained with PAS, 4,3% were classed IM-positive. PAS sensibility was 90%. The two special stains (AB and PAS) have made no diagnostic gain.

Conclusions: Routine special stains for every single gastric and/or esophageal biopsy are not required and H&E assessment combined with selective ordering of these stains will identify all cases of H. pylori gastritis and IM.


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