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Warthin-Starry Staining for the Detection of Helicobacter pylori in Gastric Biopsies

Wirda Indah Farouk1, Nur Hidayah Hassan1, Teh Rasyidah Ismail1

  • 1Universiti Kuala Lumpur, Institute of Medical Science & Technology (UNIKL MESTECH), 43000 Kajang, Selangor, Malaysia.

The Malaysian Journal of Medical Sciences : MJMS
|March 28, 2019
PubMed
Abstract

Insights

Warthin-Starry (WS) staining showed lower sensitivity for detecting Helicobacter pylori in gastric biopsies compared to immunohistochemistry (IHC). Further patient history is needed for accurate WS stain diagnosis.

Area of Science:

  • Gastroenterology
  • Histopathology
  • Infectious Diseases

Background:

  • Warthin-Starry (WS) staining is an ancillary method for identifying microorganisms in tissue.
  • Its utility in confirming Helicobacter pylori (H. pylori) diagnosis in gastric biopsies requires validation.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of WS staining for H. pylori in gastric biopsies.
  • To compare WS staining with anti-H. pylori immunohistochemistry (IHC) staining.

Main Methods:

  • Analysis of 104 gastric biopsy cases previously stained with WS.
  • Re-staining of formalin-fixed paraffin-embedded (FFPE) biopsies using anti-H. pylori IHC.
  • Blind pathological review and calculation of sensitivity, specificity, PPV, and NPV for WS stain against IHC.

Main Results:

  • WS stain demonstrated a sensitivity of 50.0% and specificity of 92.4%.
  • Positive predictive value (PPV) was 79.2%, and negative predictive value (NPV) was 76.3%.
  • WS stain exhibited lower sensitivity for H. pylori detection than previously reported.

Conclusions:

  • The sensitivity of WS stain for H. pylori in this study was suboptimal.
  • External factors may influence WS staining results.
  • Patient treatment and medication history are crucial for accurate H. pylori diagnosis using WS stain.
Keywords:
H. pyloriWarthin-Starrynegative predictive valuepositive predictive valuesensitivityspecificity

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