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The role of immunohistochemical expression of H. pylori antigen and special stain for H. pylori in atrophic and non-atrophic gastritis in a sample of Iraqi patients with chronic dyspepsia
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| Author:
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ASMAA MOHAMMED MEKKEY, MARIUM MOHAMMED BURHAN, HAMEDA ABDULL AL-MAHDI, HAYDER ABDUL AMIR MAKKI AL-HINDY
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| Abstract:
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Background: One of the important organs related to the human gastrointestinal tract is the stomach which is a hollow muscular dilated structure to receive food and is located between the esophagus above and the duodenum below. Detection of H. pylori may be done using gastric biopsy that is going to be stained by a special stain or the use of immunohistochemistry to detect specific bacterial antigens. However, the sensitivity, specificity, and cost of different histological methods are highly variable and no test is widely accepted in routine histological evaluation of gastric biopsy till now.
Aim of the study: the current study was planned and conducted to evaluate the role of immunohistochemistry in the diagnosis of H. pylori and its correlation with histological changes in a sample of Iraqi patients vesting the gastroenterology unit at Al-Diwaniyah Teaching hospital in Al-Diwaniyah province, Iraq.
Materials and methods: The current study was carried out at the central laboratory of Al-Diwaniyah teaching hospital and several private histopathology laboratories in Al-Diwaniyah province, a mid-Euphrates region of Iraq. The study was started in June 2019 and ended in December 2019. Thirty 4 paraffin sections of the gastric biopsy were retrieved from these laboratories. One section was made from each paraffin block and stained by the conventional hematoxylin and eosin (H & E) stain to be reviewed by two pathologists who confirmed the diagnosis and other related histological features. One further section was made for immunohistochemical staining H. pylori antigen.
Results: The immunohistochemistry was regarded as the gold standard test, while, H and E stain was contrasted to it. According to immunohistochemistry, there were 29 cases with positive H. pylori and 5 cases with negative H. pylori results. The sensitivity of H and E stain in detecting H. pylori was poor, 41.4 %; however, its specificity was excellent (100 %). The positive predictive value was also excellent (100.0 %), but the negative predictive value was low (22.7 %). The overall accuracy of H and E stain was also poor (50.0 %).
Conclusion: Based on our results and the results obtained from many previously printed reports, it appears that immunohistochemistry should be used routinely in evaluating gastric biopsies because of its high sensitivity, high specificity, and relatively low cost.
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| Keyword:
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immunohistochemical, H. pylori antigen, gastritis, Iraq
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.SP2. 490
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| Download:
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