scholarly journals Comparison of Immunohistochemistry and Conventional Stains for Helicobacter Pylori Detection in Gastric Biopsies of Patients Receiving Proton Pump Inhibitors

2020 ◽  
Author(s):  
Kongsak Loharamtaweethong ◽  
Napaporn Puripat
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Giemsa Staining ◽  
P Value ◽  
Predictive Values ◽  
Staining Methods ◽  
Gastric Biopsies ◽  
H Pylori ◽  
Sensitivity Specificity

Objective: To evaluate the diagnostic performance of different staining methods for Helicobacter pylori (H. pylori) in patients treated with proton pump inhibitors (PPI) Material and Methods: This is a retrospective study involving 75 gastric biopsies from patients with and without PPI therapy between October 2018 and September 2019. Slides were stained with hematoxylin and eosin (H&E); Giemsa and immunohistochemical staining (IHC) was done using polyclonal anti-H. pylori antibodies. Statistical analysis was performed to determine any association between the results of different staining methods and PPI consumption. Sensitivity, specificity and positive-negative predictive values of H&E and Giemsa stains were calculated. Results: Overall, H. pylori infection was detected in 33.3% of patients using IHC, 26.7% using H&E, and 28.0% via Giemsa staining. A strong correlation was found between PPI consumption and low H. pylori density detected via IHC (p-value=0.015) but not using H&E and Giemsa staining. The sensitivity of H&E and Giemsa was markedly reduced as a result of PPI consumption (57.1% to 18.2% vs. 85.7% to 27.3%, respectively). Conclusion: Identification of H. pylori using IHC in patients treated with PPI was superior to H&E and Giemsa stains. Both H&E and Giemsa stains showed a marked decrease in sensitivity in patients receiving PPI. The results indicate that IHC should be performed in patients with PPI therapy instead of H&E or Giemsa stains, and PPI should be discontinued for at least 14 days before the performance of endoscopy.

scholarly journals Different dose of new generation proton pump inhibitors for the treatment of Helicobacter pylori infection: A meta-analysis

2021 ◽  
Vol 35 ◽  
pp. 205873842110303
Author(s):  
Wenwen Gao ◽  
Xiang Zhang ◽  
Yanhui Yin ◽  
Shuwen Yu ◽  
Lu Wang
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Eradication Rate ◽  
Standard Dose ◽  
Statistical Significance ◽  
High Dose ◽  
Clarithromycin Resistance ◽  
H Pylori ◽  
New Generation

The evidence on whether high-dose new generation proton pump inhibitors (PPIs) including rabeprazole and esomeprazole achieve a higher eradication rate of Helicobacter pylori has not been assessed. The primary comparison was eradication and adverse events (AEs) rate of standard (esomeprazole 20 mg bid, rabeprazole 10 mg bid) versus high-dose (esomeprazole 40 mg bid, rabeprazole 20 mg bid) PPIs. Sub-analyses were performed to evaluate the eradication rate between Asians and Caucasians, clarithromycin-resistance (CAM-R) strains, and clarithromycin-sensitivity (CAM-S) strains of different dose PPIs. We conducted a literature search for randomized controlled trials comparing high-with standard-dose esomeprazole and rabeprazole for H. pylori eradication and AEs. A total of 12 trials with 2237 patients were included. The eradication rate of high-dose PPIs was not significantly superior to standard-dose PPIs regimens: 85.3% versus 84.2%, OR 1.09 (0.86–1.37), P = 0.47. The high dose induced more AEs than those of the standard dose, but didn’t reach statistical significance (OR 1.25, 95% CI: 0.99–1.56, P = 0.06). Subgroup analysis showed that the difference in eradication rate of PPIs between high- and standard-dose groups were not statistically significant both in Asians (OR 0.99, 95% CI 0.75–1.32, P = 0.97) and Caucasians (OR 1.27, 95% CI 0.84–1.92, P = 0.26). Furthermore, there were similar eradication rates in CAM-S (OR 1.2; 95% CI 0.58–2.5; P = 0.63) and CAM-R strains (OR 1.08; 95% CI 0.45–2.56; P = 0.87) between the standard-and high-dose groups. High and standard dosages of new generation of the PPIs showed similar H. pylori eradication rates and AEs as well as between Asian versus Caucasian populations, with or without clarithromycin-resistance. However, further studies are needed to confirm.

scholarly journals Evaluation of Better Staining Method among Hematoxylin and Eosin, Giemsa and Periodic Acid Schiff-Alcian Blue for the Detection of Helicobacter pylori in Gastric Biopsies

2020 ◽  
Vol 27 (5) ◽  
pp. 53-61
Author(s):  
Abdullah Saleh Alkhamiss
Keyword(s):  
Helicobacter Pylori ◽  
Alcian Blue ◽  
National Guard ◽  
Periodic Acid ◽  
Giemsa Stain ◽  
Periodic Acid Schiff ◽  
Gastric Biopsies ◽  
Hematoxylin And Eosin ◽  
H Pylori ◽  
Sensitivity Specificity

Background: This study was undertaken to evaluate the preferred method (Giemsa or periodic acid Schiff-Alcian blue [PAS-AB] stains) of detecting Helicobacter pylori (H. pylori) in gastric mucosal biopsies in terms of sensitivity, specificity and applicability. To the best of my knowledge, this is the first report comparing Giemsa and PAS-AB staining for the detection of H. pylori in such biopsies. Methods: The formalin-fixed paraffin-embedded blocks of 49 gastric biopsies from different patients were collected from the archive of anatomical pathology at King Abdulaziz Medical City, National Guard, Riyadh, Saudi Arabia. From each block, three slides were prepared and analysed using the hematoxylin and eosin (H&E), Giemsa and PAS-AB stains to detect the presence/absence of H. pylori, and the results were compared in terms of sensitivity, specificity and applicability. Results: The majority of the biopsies in this study showed antrum-type gastric mucosa. Only 15 biopsies showed active gastritis, whereas the rest showed chronic gastritis. Three biopsies showed intestinal metaplasia. All were detected by PAS-AB stain, but only two-thirds were detected by H&E stain. Fifteen gastric biopsies showed H. pylori infection in general and in 13 of them, active gastritis cases were discovered. Fourteen out of these 15 H. pylori infection cases were detected by Giemsa stain, whereas only 13 cases were detected by H&E stain. PAS-AB stain showed the worst results since it demonstrated only 40% sensitivity and 67.65% specificity in H. pylori detection. Conclusion: Giemsa stain has better sensitivity and specificity in gastric H. pylori infection detection than PAS-AB. Therefore, using PAS-AB stain to detect H. pylori infection is not recommended.

Good diagnostic accuracy of a chemiluminescent immunoassay in stool samples for diagnosis of Helicobacter pylori infection in patients with dyspepsia

2016 ◽  
Vol 64 (2) ◽  
pp. 388-391 ◽  
Author(s):  
María José Ramírez-Lázaro ◽  
Josep Lite ◽  
Sergio Lario ◽  
Pepa Pérez-Jové ◽  
Antònia Montserrat ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gold Standard ◽  
Rapid Urease Test ◽  
Diagnostic Reliability ◽  
Predictive Values ◽  
Urease Test ◽  
Stool Samples ◽  
H Pylori ◽  
Good Diagnostic Accuracy ◽  
Sensitivity Specificity

Laboratory-based chemiluminescence immunoassays (CLIA) are widely used in clinical laboratories. Some years ago, a CLIA test was developed for the detection of Helicobacter pylori in stool samples, known as LIAISON H. pylori SA, but little information on its use has been reported. To evaluate the accuracy of the LIAISON H. pylori SA assay for diagnosing H. pylori infection prior to eradication treatment. Diagnostic reliability was evaluated in 252 untreated consecutive patients with dyspepsia. The gold standard for diagnosing H. pylori infection was defined as the concordance of the rapid urease test (RUT), histopathology and urea breath test (UBT). The CLIA assay was performed according to the manufacturer's instructions. Sensitivity, specificity, positive and negative predictive values, and 95% CIs were calculated. According to the gold standard selected, 121 patients were positive for H. pylori infection and 131 negative. LIAISON H. pylori SA had a sensitivity of 90.1% and a specificity of 92.4%, with positive and negative predictive values of 91.6% and 90.1%, respectively. The accuracy of the LIAISON H. pylori SA chemiluminescent diagnostic assay seems comparable to that of ELISA or the best-performing LFIAs. Its sensitivity and specificity, however, seem slightly lower than those of histology, RUT or UBT. The advantages of the assay are that it is cheap, automated, and minimally labor-intensive.

scholarly journals Are Histopathological Changes of H. pylori Infection in Young Dyspeptic Patients Necessitate Endoscopy?

2019 ◽  
Vol 7 (19) ◽  
pp. 3211-3215
Author(s):  
Wafaa Redha Mohammed Al-Sabbagh ◽  
Alaa Qasim Yahya ◽  
Rasha Abdelraouf Alsafi
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Lymphoma ◽  
Young Patients ◽  
Chronic Atrophic Gastritis ◽  
Gastric Biopsy ◽  
P Value ◽  
Histopathological Changes ◽  
Gastric Biopsies ◽  
Antigen Tests ◽  
H Pylori

BACKGROUND: Helicobacter pylori is an important gastrointestinal infective bacteria with many serious complications including gastric erosions and ulceration, duodenal ulcer, gastric carcinoma and MALT gastric lymphoma. The gastric biopsy is commonly performed in H. pylori-positive dyspeptic individuals, and many previous researchers studied the histopathological features of infected gastric biopsies however little previous studies focused on the histopathological findings in young population in comparison to the older one. AIM: To make a focus on the histopathological effects of H. pylori infection in young patients compared with the older one and predicts the need for endoscopy in this population, also to estimates the prevalence of infection in Iraqi patients. MATERIAL AND METHODS: the sample for this study is 180 patients in total, they attended Marjan medical city in Iraq for dyspepsia of more than 3 months and prepared for OGD. Patients asked for their permission to do immunological tests for H. pylori. Both serology for H. pylori antibodies and stool for antigen tests are used, and the case is included in the study only if both tests were positive, after OGD, the gastric biopsies are processed and examined histopathologically. RESULTS: Normal gastric biopsy is the most common histopathological finding in young (< 25 years) patients (75%) while chronic atrophic gastritis is the most common one in patients > 25 years age (57%). The prevalence of Helicobacter pylori infection in dyspeptic patients was 73.3%, the correlation between infection and sex was insignificant (p-value 0.06), and no significant correlation between infection and age (p-value 0.07) was concluded. CONCLUSION: H. pylori-related histopathological changes of gastric mucosa in young (< 25 years) are commonly mild and does not necessitate endoscopy at this age unless there are alarming signs.

Comparative Effect of Proton-Pump Inhibitors on the Success of Triple and Quadruple Therapy for Helicobacter pylori Infection

2020 ◽  
Vol 38 (5) ◽  
pp. 408-414 ◽  
Author(s):  
Doron Boltin ◽  
Zohar Levi ◽  
Rachel Gingold-Belfer ◽  
Hemda Schmilovitz-Weiss ◽  
Tzippy Shochat ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Treatment Success ◽  
Helicobacter Pylori Infection ◽  
Comparative Effect ◽  
Quadruple Therapy ◽  
13C Urea Breath Test ◽  
H Pylori ◽  
Current Guidelines

Introduction: Suppression of gastric acid secretion with proton-pump inhibitors (PPI) is an integral part of the treatment of Helicobacter pylori infection. Esomeprazole has been shown to be superior to other PPIs when used in the context of triple therapy; however, comparative data for PPI efficacy in quadruple therapy are lacking. Current guidelines recommend H. pylori eradication with quadruple therapy in areas with high clarithromycin resistance. Objective: To determine whether esomeprazole is more effective than other PPIs in the context of quadruple therapy for H. pylori eradication. Methods: We retrospectively identified 25- to 60-year-old subjects with a positive 13C-urea breath test and no prior laboratory or endoscopic test for H. pylori infection. Pharmacy dispensation data were retrieved. Results: A total of 7,896 subjects including 2,856 (36.2%) males, aged 40.4 ± 10.6 years, were identified. Of those, 78.1% received omeprazole, 20.1% received lansoprazole, 1.5% received esomeprazole, and 0.34% received pantoprazole together with antibiotics for H. pylori eradication. Esomeprazole was associated with a greater proportion of successful eradication (85.0 vs. 77.5%, esomeprazole vs. omeprazole, OR 1.64; 95% CI 0.99–2.72; p = 0.05). A nonsignificant trend favored esomeprazole over omeprazole among subjects receiving quadruple therapy (90.0 vs. 82.0%, respectively, OR 1.98; 95% CI 0.68–5.72; p = 0.16). Independent predictors of treatment success included older age and quadruple therapy. Conclusion: Esomeprazole is more beneficial than other PPIs for H. pylori eradication. Studies with larger subgroups are necessary to confirm our findings among subjects receiving quadruple therapy.

scholarly journals Efficacy of immunohistochemical staining in detecting Helicobacter pylori in Saudi patients with minimal and atypical infection

2021 ◽  
Vol 65 (3) ◽  
Author(s):  
Mohammed Akeel ◽  
Ahmed Elhafey ◽  
Atef Shehata ◽  
Erwa Elmakki ◽  
Thanaa Aboshouk ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Direct Detection ◽  
Giemsa Staining ◽  
Pcr Analysis ◽  
Qrt Pcr ◽  
Urease Test ◽  
Gastric Biopsies ◽  
Polymerase Chain ◽  
H Pylori

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.

scholarly journals Specific Therapeutic Schemes of Omeprazole Affect the Orientation of Helicobacter pylori

2009 ◽  
Vol 53 (8) ◽  
pp. 3511-3514 ◽  
Author(s):  
Marina Azevedo-Vethacke ◽  
Désirée Garten ◽  
Claudia Groll ◽  
Sören Schreiber
Keyword(s):  
Helicobacter Pylori ◽  
Spatial Distribution ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Spatial Orientation ◽  
Mongolian Gerbils ◽  
Gastric Mucus ◽  
Once Daily ◽  
H Pylori

ABSTRACT Until now, it has been unclear how proton pump inhibitors (PPIs) support Helicobacter pylori therapy. We tested whether the PPI omeprazole acts on the spatial orientation of H. pylori in the gastric mucus of infected Mongolian gerbils. Following repetitive PPI administration once daily but not following single doses or administration every 8 h, the bacterial spatial distribution changed, indicating a loss of orientation. Therefore, the therapeutic scheme of PPI administration may affect efficiency of treatment.

scholarly journals Oxygen concentration influences proton pump inhibitor activity against Helicobacter pylori in vitro.

1996 ◽  
Vol 40 (6) ◽  
pp. 1531-1533 ◽  
Author(s):  
P D Midolo ◽  
J D Turnidge ◽  
J R Lambert ◽  
J M Bell
Keyword(s):  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Oxygen Concentration ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Atmospheric Conditions ◽  
Inhibitor Activity ◽  
Agar Dilution ◽  
H Pylori

Omeprazole and lansoprazole are proton pump inhibitors that have shown activity against Helicobacter pylori and other Helicobacter species when tested by agar dilution. Lansoprazole was more active against H. pylori than was omeprazole, and the activity was independent of urease production. Disk susceptibility tests and agar dilution MIC determinations were performed to investigate the effects of incubation under different sets of atmospheric conditions on H. pylori inhibition. Oxygen concentration was found to influence proton pump inhibitor activity in vitro, with higher concentrations leading to greater susceptibility. The method of testing is important in determining the anti-Helicobacter activity of proton pump inhibitors.

scholarly journals Efficacy of immunohistochemical staining in detecting Helicobacter pylori in Saudi patients with minimal and atypical infection

2020 ◽  
Author(s):  
Mohammed Abdulraheem Akeel ◽  
Ahmed Elhafey ◽  
Atef Shehata ◽  
Erwa Elmakki ◽  
Thanaa Aboshouk ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Diagnostic Accuracy ◽  
False Positive ◽  
Direct Detection ◽  
Giemsa Staining ◽  
Pcr Analysis ◽  
Qrt Pcr ◽  
Urease Test ◽  
Gastric Biopsies ◽  
H Pylori

Abstract Background 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 dyspeptic patients with minimal and/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). Results 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 false-positive rates of H&E and modified Giemsa staining were 16% and 14%, respectively. 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. Conclusions H. pylori can be detected using routine H&E or modified Giemsa staining. However, the high sensitivity, specificity, and diagnostic accuracy of IHC staining minimise the false-positive/negative results and enable 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.

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