Abstract
BackgroundWarthin-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.MethodsThis 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.ResultsIn 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.ConclusionsThe 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.
Highlights
Helicobacter pylori is a microorganism that can be found in the stomach and is known to be pathogenic
The gastric resection specimens and biopsies that were subjected to Giemsa staining for the detection of H. pylori were excluded from this study
In order to determine the validity of the WS staining results, the formalin-fixed paraffin-embedded (FFPE) blocks from WS-stained cases were further re-sectioned and subjected to IHC staining
Summary
Helicobacter pylori is a microorganism that can be found in the stomach and is known to be pathogenic. Prolonged or untreated infection may predispose to gastric carcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma [1, 2]. H. pylori is known to have an oncogenic role, which is exhibited during the inflammatory process that involves specific genes and increased the virulence of H. pylori to cancer [3]. 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
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