Molyneux A J, Harris M D
Addenbrooke's Hospital, Cambridge.
J R Coll Physicians Lond. 1993 Apr;27(2):119-20.
The presence of Helicobacter pylori in gastric biopsies is closely associated with gastritis and duodenal ulceration. We have assessed the reliability of H pylori identification on haematoxylin and eosin (H & E) stained sections of gastric biopsies showing gastritis. A set of 20 slides was shown to 20 histopathologists (a total of 400 diagnoses); 11 of them were H pylori-positive, assessed using two special stains. Participants were asked to comment on the presence or absence of H pylori on H & E alone. The overall detection rate in positive cases was 66%. All pathologists missed at least one case, and there were 25 false-positive diagnoses overall. We conclude that identification of H pylori is unreliable in gastric biopsies if H & E alone is used. Clinicians who use the presence of H pylori as a basis for treatment should be aware of this problem.
胃活检中幽门螺杆菌的存在与胃炎和十二指肠溃疡密切相关。我们评估了在显示胃炎的胃活检苏木精和伊红（H&E）染色切片上鉴定幽门螺杆菌的可靠性。向20位组织病理学家展示了一组20张玻片（总共400次诊断）；其中11张使用两种特殊染色评估为幽门螺杆菌阳性。要求参与者仅根据H&E染色对幽门螺杆菌的存在与否发表意见。阳性病例的总体检出率为66%。所有病理学家至少漏诊了1例，总体共有25例假阳性诊断。我们得出结论，如果仅使用H&E染色，在胃活检中鉴定幽门螺杆菌是不可靠的。将幽门螺杆菌的存在作为治疗依据的临床医生应意识到这个问题。
