A new staining method for identification of Helicobacter pylori and simultaneous visualization of gastric morphologic...

Helicobacter pylori (HP) is prevalent in the general population and is associated with chronic active gastritis, peptic ulcers, gastric carcinoma, and lymphoma. Different methods to diagnose HP colonization include the urea breath test, serologic analysis, and gastric biopsy. Many different staining methods, including silver and Giemsa-based stains, have been used to demonstrate these organisms in gastric biopsy specimens. The tissue morphologic features, however, are often obscured, thus mandating evaluation of both hematoxylin and eosin (H&E) and special stains. This study evaluates the ability of a new staining method that allows simultaneous identification of HP and visualization of tissue morphologic features. We examined formalin-fixed, paraffin-embedded archival tissues from 184 consecutive gastric biopsy specimens using our new staining method, and we compared our results with those previously obtained from H&E and Warthin-Starry (WS) stains. Our new stain uses periodic acid-Schiff, Coleman's Feulgen solution, Mayer's hematoxylin, and methylene blue. Our method is technically simpler than the WS stain and can be completed in approximately 9 minutes. We found HP organisms in 76 (41%) of 184 biopsy specimens by H&E and/or WS staining. Our new staining method identified HP in 83 specimens (45%). The organisms stained bright blue and were easily visualized (compared with the H&E-stained specimens) because of the contrasting magenta mucin. Tissue morphologic features consisted of well-defined cells with dark blue nuclei and pale cytoplasm. Intestinal metaplasia was highlighted magenta Our new staining method revealed chronic active gastritis in 71 cases (39%), intestinal metaplasia in 18 cases (10%), and lymphoid aggregates in 35 cases (19%). These findings were similar to the results obtained with H&E-stained sections. We conclude that our new staining method is inexpensive, quick, and easy to perform and interpret. It has a sensitivity comparable to that of conventional staining methods and simultaneously demonstrates both tissue morphologic features and the presence of HP.