USE OF ROUTINE SPECIAL STAINS FOR GASTRIC AND ESOPHAGEAL BIOPSIES

O. Belkacem
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Abstract

Problem: Special stains such as the Giemsa, the Alcian blue (AB) and the Periodic Acid Schiff (PAS) are widely used for gastric and/or esophageal biopsies for the diagnosis of Helicobacter pylori (H. pylori) and intestinal metaplasia (IM). The purpose of our study was to determine if these stains are actually needful Methods: We retrospectively studied 209 gastric and esophageal biopsies. We evaluated the H. pylori status on hematoxylin and eosin (H&E) stained slides and the presence of IM and finally we examined the special stains. Results: 23% of cases were H. pylori-positive. H&E stain had a high degree of accuracy (92,1%). The Giemsa stain was positive in 23,7% and negative in 71,8%. The Giemsa was useful in 16,7% biopsies. The AB revealed goblet cells in 4,8% cases. AB sensibility was 90,9%. From the 208 slides stained with PAS, 4,3% were classed IM-positive. PAS sensibility was 90%. The two special stains (AB and PAS) have made no diagnostic gain. Conclusions: Routine special stains for every single gastric and/or esophageal biopsy are not required and H&E assessment combined with selective ordering of these stains will identify all cases of H. pylori gastritis and IM.
胃和食管活检常规特殊染色的使用
问题:特殊染色,如吉姆萨、阿利新蓝(AB)和周期性酸性希夫(PAS)被广泛用于胃和/或食管活检,以诊断幽门螺杆菌(H. pylori)和肠化生(IM)。我们研究的目的是确定这些染色是否真的需要。方法:我们回顾性研究了209例胃和食管活检。我们评估了苏木精和伊红(H&E)染色玻片上幽门螺杆菌的状态和IM的存在,最后我们检查了特殊的染色。结果:23%的病例幽门螺旋杆菌阳性。H&E染色具有很高的准确度(92.1%)。吉姆萨染色阳性的占23.7%,阴性的占71.8%。在16.7%的活组织检查中,吉姆萨检查是有用的。在4.8%的病例中,AB显示杯状细胞。AB敏感性为90.9%。在208张PAS染色的载玻片中,4.3%为im阳性。PAS敏感性为90%。两种特殊的染色(AB和PAS)没有诊断上的收获。结论:不需要对每一次胃和/或食管活检进行常规的特殊染色,H&E评估结合这些染色的选择性排序将识别所有幽门螺杆菌胃炎和IM病例。
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