Comparative Efficacy of Various Histological Staining Methods for Demonstration of Helicobacter Pylori in Gastric Biopsies

Background Helicobacter pylori is a spiral, flagellated bacterium having abundant urease production capacity. H. pylori bacterium has been implicated in various gastrointestinal disorders including gastritis, gastroduodenal ulcers, mucosa associated lymphoid tissue lymphoma and gastric cancer. Histology is a gold standard technique for the detection of H. pylori. This study aims to evaluate various histological staining methods used for the demonstration of H. pylori in gastric biopsies. Method This study was conducted in the department of Pathology. A total of 100 gastric biopsies were analyzed for the presence of H. pylori with the use of three different histological stains. The Sensitivity, Specificity, Negative predictive value (NPV), Positive predictive value(PPV) and Diagnostic accuracy (DA) of the stains were calculated. Result H. pylori was detected in total 32 gastric biopsy samples. Males (41.6%) were found to be affected more than females (23%) with middle-aged individuals showing the highest susceptibility. Highest frequency of H. pylori was detected by Giemsa stain followed by Gimenez stain and hematoxylin and eosin (H&E) stain. The result of Gimenez stain was superior to H&E stain and comparable to Giemsa stain. The Sensitivity, Specificity, PPV, NPV and DA of H&E stain was 74.19%, 100%, 100%, 89.61%, 92% and Gimenez stain was 96.7%, 100%, 100%, 98.57% ,99%. Conclusion Giemsa stain has better diagnostic accuracy than traditional H&E stain and Gimenez stain for demonstration of H. pylori in gastric biopsies while Gimenez stain has better Sensitivity, Specificity and diagnostic accuracy than H&E stain. Thus, both Giemsa and Gimenez stains are recommended for the detection of H. pylori in gastric biopsies.