Comparative Study of Some Staining Methods for the Demonstration of Helicobacter pylori in Gastric Biopsies in Gombe State, Nigeria

Background: Currently there are different staining methods available for the demonstration of Helicobacter pylori in gastric biopsies sections. Most of these methods are technically demanding, slow and expensive with varying sensitivity and specificity.

Aims: This study was to compare some of these techniques for the detection of H. pylori in routine gastric biopsy tissue sections in order to ascertain their reliability and effectiveness.

Methodology: Sixty-five positive and seven negative cases of H. pylori were selected based on the results of rapid urease test, serology test and histopathological examination of the tissue sections. Histopathological examinations of sections stained by Hematoxylin and Eosin staining method (H&E), Giemsa staining method, modified Giemsa staining method, modified McMullen staining method and immunohistochemical staining were performed.

Results: The sections were evaluated by two independent observers. The sensitivity and specificity for the techniques were as follow: immunohistochemistry, 100% and 100%; modified Giemsa stain, 96.9% and 85.7%; Giemsa stain, 92.3% and 81.4%; modified McMullen stain, 89.2% and 52.9%; H&E, 90.8% and 77.1%. The interobserver agreement was analyzed by Kappa (k) statistics using SPSS version 23 software. The agreement between the two observers was k: 0.859 (98.4%) for immunohistochemistry; k: 0.777 (96.9%) for modified Giemsa stain; k: 0.533 (95.2%) for Giemsa stain; k: 0.267 (92.1%) for modified McMullen stain; and k: 0.421 (93.7%) for H&E stain.

Conclusion: The best results were obtained by the immunohistochemical staining and the Giemsa stainings. Although the immunohistochemistry staining method gives the best result and is very reliable, but it is fairly time consuming and expensive. Therefore, considering the cost, applicability and the reliability of the modified Giemsa or Giemsa stain, we recommend both for the detection of H. pylori in gastric biopsies sections especially in resource constrained laboratories.