Helicobacter pylori in gastric biopsies--should you trust the pathology report?
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.
Molyneux
A J
AJ
Addenbrooke's Hospital, Cambridge.
Harris
M D
MD
D001707:Biopsy, Needle; D004801:Eosine Yellowish-(YS); D005189:False Positive Reactions; D005753:Gastric Mucosa / Q000382:microbiology*; D005756:Gastritis / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006416:Hematoxylin; D006801:Humans; D015588:Observer Variation; D015203:Reproducibility of Results; D013194:Staining and Labeling
D004801:Eosine Yellowish-(YS); D006416:Hematoxylin