High Correlation of Immunohistochemical (IHC) Staining of Gastric Biopsies from Multiple Sites for H. pylori

Abstract

Purpose: IHC staining of gastric biopsies is highly sensitive and specific for detection of H. pylori. We hypothesize that this IHC staining-based high sensitivity and specificity should obviate the need for multi-sites gastric biopsies at the time of gastroscopy. The aim is to assess the correlation of immunohistochemical (IHC) staining of gastric biopsies from multiple sites for H. pylori. Methods: Review of gastroscopy procedures performed between January 2011 and June, 20011. Inclusion criteria: multi-sites gastric biopsies (three or more sites), stained by IHC staining for H. pylori. All the slides were reviewed by one pathologist. Results: 302 consecutive gastroscopies with biopsies were performed during the period between January and June, 2011. 92 biopsies were excluded (obtained for reasons other than H. pylori detection). Of 210 included, 162 were negative for H. pylori, and 48 were positive on IHC staining. In 44 cases, all gastric zonal biopsies (antrum, body, incisura) were positive on IHC staining, while in 2 cases, only antral biopsies were positive, and two cases, positive for H. pylori on either body or incisura biopsies. (Table 1, Figure 1)Table: H. pylori + ve Gastric Biopsies on IHC StainingFigure: No Caption available.Conclusion: There is high agreement for detection of H. pylori of IHC-stained biopsies obtained from antrum, body or incisura. Based on these data, unless there is other indications for additional gastric biopsies, (e.g., ulcer or lesion), IHC stained- antral biopsy is probably sufficient for detection of H. pylori.