Detection of Helicobacter pylori (H. pylori) by histochemical stains in gastric biopsy comparing to immunohistochemistry

Aim: A reliable diagnosis of Helicobacter pylori (H. pylori) is important in clinical practice and research. The aim of this study was to compare the sensitivity and specificity of Giemsa stain with hematoxylin and eosin (H&E), Toluidine blue, Gimenez and Warthin-Starry stain in detection of Helicobacter pylori (H. pylori) in gastric biopsy and also with immunohistochemistry (IHC) stain in detection of H. pylori organism in gastric biopsy. Method: A retrospective cross-sectional included 200 formalin-fixed paraffin-embedded (FFPE) gastric biopsies of age between 25 to 80 years in histopathology Laboratory at Alzaytouna Specialist Hospital, Khartoum, Sudan. The samples were sectioned and stained with H&E, Giemsa, Toluidine blue, Gimenez, Warthin-Starry silver, and IHC stains. Result: Our study showed IHC yielded (40%) positive cases while (60%) were negative. all stains had 100% sensitivity in detection H. pylori. The specificities were 100% for toluidine blue and Gimenez stains, 92.3% for Warthin-Starry stain, 85.7% for Giemsa stain, and 82.8% for H&E stain. Conclusion: Toluidine blue and Gimenez stain are more specific in detecting H. pylori organism than Giemsa, H&E and Warthin-Starry but are less sensitive than the later.