Appropriate use of special stains for identifying helicobacter pylori

Recommendations from the Rodger C. Haggitt gastrointestinal pathology society

Kenneth P. Batts, Scott Ketover, Sanjay Kakar, Alyssa M. Krasinskas, Kisha A. Mitchell, Rebecca Wilcox, Maria Westerhoff, Joseph Rank, Joanna Gibson, Anthony R. Mattia, Oscar Cummings, Jon M. Davison, Bita V. Naini, Sarah M. Dry, Rhonda K. Yantiss

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Helicobacter pylori is a major cause of gastroduodenal injury, gastric cancer, and lymphoma, and, thus, there is great interest in its detection and eradication. Several detection methods are available, including histochemical and immunohistochemical stains. Application of these stains in clinical practice is heterogenous, to say the least. Although they were developed to enhance H. pylori detection, changing practice models, financial considerations, and a perceived need for rapid case turnaround have led to their widespread use in routine staining studies ordered reflexively on all gastric biopsies. Emerging data suggest that most of these stains are not needed to establish a diagnosis of H. pylori infection, and their added value when biopsies show minimal, or no, inflammation is not clear. In this manuscript, the Rodger C. Haggitt Gastrointestinal Pathology Society puts forth recommendations regarding ancillary stain usage for H. pylori detection based upon critical literature review and collective experience. Pathologists rarely, if ever, detect H. pylori in "normal" biopsies, but readily observe them in optimally stained hematoxylin and eosin sections from infected patients. Therefore, we suggest that use of ancillary stains is appropriate when biopsies show chronic, or chronic active, gastritis without detectable H. pylori in hematoxylin and eosin-stained sections, but performing them "up front" on all gastric biopsies is generally unnecessary. Application of these stains to nongastric biopsies and polyps is appropriate in an extremely limited set of circumstances. It is our hope that recommendations provided herein will provide helpful information to gastroenterologists, pathologists, and others involved in the evaluation of patients for possible H. pylori infection.

Original languageEnglish (US)
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number11
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Helicobacter pylori
Coloring Agents
Pathology
Biopsy
Helicobacter Infections
Hematoxylin
Eosine Yellowish-(YS)
Stomach
Gastritis
Polyps
Stomach Neoplasms
Staining and Labeling
Inflammation
Wounds and Injuries

Keywords

  • ancillary
  • gastritis
  • immunohistochemistry
  • reflex testing
  • up front

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Appropriate use of special stains for identifying helicobacter pylori : Recommendations from the Rodger C. Haggitt gastrointestinal pathology society. / Batts, Kenneth P.; Ketover, Scott; Kakar, Sanjay; Krasinskas, Alyssa M.; Mitchell, Kisha A.; Wilcox, Rebecca; Westerhoff, Maria; Rank, Joseph; Gibson, Joanna; Mattia, Anthony R.; Cummings, Oscar; Davison, Jon M.; Naini, Bita V.; Dry, Sarah M.; Yantiss, Rhonda K.

In: American Journal of Surgical Pathology, Vol. 37, No. 11, 11.2013.

Research output: Contribution to journalArticle

Batts, KP, Ketover, S, Kakar, S, Krasinskas, AM, Mitchell, KA, Wilcox, R, Westerhoff, M, Rank, J, Gibson, J, Mattia, AR, Cummings, O, Davison, JM, Naini, BV, Dry, SM & Yantiss, RK 2013, 'Appropriate use of special stains for identifying helicobacter pylori: Recommendations from the Rodger C. Haggitt gastrointestinal pathology society', American Journal of Surgical Pathology, vol. 37, no. 11. https://doi.org/10.1097/PAS.0000000000000097
Batts, Kenneth P. ; Ketover, Scott ; Kakar, Sanjay ; Krasinskas, Alyssa M. ; Mitchell, Kisha A. ; Wilcox, Rebecca ; Westerhoff, Maria ; Rank, Joseph ; Gibson, Joanna ; Mattia, Anthony R. ; Cummings, Oscar ; Davison, Jon M. ; Naini, Bita V. ; Dry, Sarah M. ; Yantiss, Rhonda K. / Appropriate use of special stains for identifying helicobacter pylori : Recommendations from the Rodger C. Haggitt gastrointestinal pathology society. In: American Journal of Surgical Pathology. 2013 ; Vol. 37, No. 11.
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