Department of Anatomy, Faculty of Medicine, Jazan University.
Department of Pathology, Faculty of Medicine, Jazan University.
Eur J Histochem. 2021 Jul 20;65(3):3222. doi: 10.4081/ejh.2021.3222.
Gastric Helicobacter pylori infection is diagnosed based on histopathological evaluation of gastric mucosal biopsies, urease test, urea breath test, H. pylori culturing, or direct detection using polymerase chain reaction (PCR). This study aimed to evaluate the efficacy of immunohistochemical (IHC) staining in detecting H. pylori in gastric biopsies from patients with chronic gastritis and minimal or atypical infection. Gastric biopsies from 50 patients with chronic gastritis were subjected to routine haematoxylin and eosin (H-E), modified Giemsa, and IHC staining. The results of staining were compared with those of quantitative real-time PCR (qRT-PCR). The qRT-PCR analysis identified 32 (64%) H. pylori-positive cases, whereas IHC, H-E, and modified Giemsa staining identified 29 (58%), 27 (54%), and 21 (42%) positive cases. The sensitivity of IHC staining (87.50%) was higher than that of H-E (59.38%) and modified Giemsa (43.75%) staining. The specificity of H-E, modified Giemsa, and IHC staining was 55.56%, 61.11%, and 94.44%, respectively. IHC staining exhibited the highest diagnostic accuracy (90%), followed by H-E (58%) and modified Giemsa (50%) staining. Active gastritis, intestinal metaplasia, and lymphoid follicles were detected in 32 (64%), 4 (8%), and 22 (44%) cases, respectively, and all of these cases were H. pylori positive. In contrast to routine H-E and modified Giemsa staining, IHC allows for the accurate H. pylori detection in cases with minimal or atypical infection. Moreover, IHC can be an alternative diagnostic method to qRT-PCR for detection of H. pylori in such cases.
胃幽门螺杆菌感染的诊断基于胃黏膜活检的组织病理学评估、尿素酶试验、尿素呼气试验、幽门螺杆菌培养或使用聚合酶链反应（PCR）直接检测。本研究旨在评估免疫组织化学（IHC）染色在检测慢性胃炎和最小或非典型感染患者胃活检中幽门螺杆菌的疗效。对 50 例慢性胃炎患者的胃活检进行常规苏木精和伊红（H-E）、改良吉姆萨和 IHC 染色。将染色结果与实时定量 PCR（qRT-PCR）的结果进行比较。qRT-PCR 分析确定了 32 例（64%）幽门螺杆菌阳性病例，而 IHC、H-E 和改良吉姆萨染色分别确定了 29 例（58%）、27 例（54%）和 21 例（42%）阳性病例。IHC 染色的敏感性（87.50%）高于 H-E（59.38%）和改良吉姆萨（43.75%）染色。H-E、改良吉姆萨和 IHC 染色的特异性分别为 55.56%、61.11%和 94.44%。IHC 染色的诊断准确性最高（90%），其次是 H-E（58%）和改良吉姆萨（50%）染色。在 32 例（64%）病例中检测到活动性胃炎、肠上皮化生和淋巴滤泡，分别为 4 例（8%）和 22 例（44%），所有这些病例均为幽门螺杆菌阳性。与常规 H-E 和改良吉姆萨染色相比，IHC 允许在最小或非典型感染的情况下准确检测幽门螺杆菌。此外，在这种情况下，IHC 可以替代 qRT-PCR 作为检测幽门螺杆菌的诊断方法。
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