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ORIGINAL ARTICLE
Year : 2021  |  Volume : 18  |  Issue : 2  |  Page : 83-88

How reliable are general histopathologists in detection of helicobacter pylori on routine histology?


Department of Pathology, College of Dentistry, Hawler Medical University, Erbil, Iraq; Examinations, RCPath, London, England, UK

Correspondence Address:
Saman S Abdulla
Department of Pathology, College of Dentistry, Hawler Medical University, Erbil

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/MJBL.MJBL_94_20

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Background: Many studies agree that routine histology is less sensitive and less specific than special stains and immunohistochemistry (IHC) with false-positive and false-negative rates. Objectives: The aim was to evaluate the accuracy of four general histopathologists in documenting Helicobacter pylori (Hp) bacteria in gastric biopsies (stained with H and E) by using IHC and modified Giemsa stain (MG), also to assess the specificity of MG and whether it can replace IHC. Materials and Methods: Twenty seven reported gastric biopsies were collected from each of four pathologists (9 reported as negative for Hp, 9 reported as scant Hp, and 9 as abundant Hp). The pathologists selected were known to have different thresholds for Hp. The biopsies were stained with MG and IHC and they were read by two pathologists. Results: The four pathologists showed different thresholds for labeling luminal gastric pits' structures as Hp. Overall, there were 5/36 false-negative cases (13.9%) and 26/72 false-positive cases (36%), most of them in the category reported as scant Hp detected. The results of MG were concordant with that of IHC in 107/108 cases. Conclusion: The overall accuracy rate of Hp detection on routine histology was 71%; false positivity was much more common than false negativity, especially when only scant Hp reported to be present. MG is a reliable stain and if done properly, it can replace the more costly IHC. When Hp identification is crucial from the clinical management of view, special stains and/or IHC should be requested.


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