Objectives: In Asia, the use of antigens from local strains led to better sensitivity rates of the serological tests to detect the anti-Helicobacter pylori antibodies than the use of antigens from Western strains because of the regional variations in H. pylori antigenicity. However, these antigenic ...
Objectives: In Asia, the use of antigens from local strains led to better sensitivity rates of the serological tests to detect the anti-Helicobacter pylori antibodies than the use of antigens from Western strains because of the regional variations in H. pylori antigenicity. However, these antigenic variations had not been evaluated in the immuno-histochemical examinations. This study was intended to investigate the comparisons of H. pylori detection among the classical staining methods like Hematoxylin and Eosin (H&E) stain, Warthin-Starry stain, and Giemsa stain, and the immunohistochemical staining methods using 3 different anti-H. pylori antibodies produced from geographically-not-related H. pylori strains . Especially, the focus was put to the difference in immunohistochemical staining depending on the antigenicities of strains, and the usability of the antibody produced from H. pylori strain 51 isolated in Korea. Methods: Using gastric endoscopy, biopsies were taken from antrum and corpus of the medical students of Gyeongsang National University in Korea, from 1997 to 2003. The gastric tissues of students whose urease test showed positive response within 1 hour underwent H&E staining, Warthin-Starry staining, Giemsa staining, and immunohisto-chemical staining with the rabbit antibodies to Helicobacter ATCC-43504 strain (Biodesign Ab), CH-20426 strain (Dako Ab), and H. pylori strain 51 (strain 51 Ab) were carried out. The grade of histopathological H. pylori densities were assessed into 0 to 6 on the basis of standard visual scale of Sydney system, by two observers independently. Grade differences were put to paired t-test, and inter-observer agreement were evaluated with gamma analysis. Results: There was difference in histopathological H. pylori grades according to staining methods. The histopathological H. pylori grades were the highest in Biodesign Ab and H. pylori strain 51 Ab produced higher histopathological H. pylori grades (P<0.001), and then Giemsa staining and Warthin-Starry staining in order. Dako Ab produced significantly lower grades, and H&E stains the lowest grade. Sensitivity was the highest in the H. pylori strain 51 Ab (96.21%, 99.31%). Biodesign Ab showed the sensitivity of 95.87%, 98.86%, Dako Ab 94.15%, 96.90%, and H&E staining 91.78%, 91.06%, the lowest. Inter-observer agreement was the highest in the H. pylori strain 51 Ab with 0.92. It was 0.87 in Biodesign Ab, 0.89 in Dako Ab, 0.88 in Warthin-Starry staining, and 0.74 in Giemsa staining. Conclusions: In the histological diagnosis of H. pylori, bacterial detection was different according to staining methods. Immunohistochemical staining methods also showed the highest H. pylori detection rate in this study. Three different anti-H. pylori antibodies produced different sensitivity in detection rate, different degree of histological H. pylori densities, and different inter-observer agreement. Immunohistochemical stains of the antibody to H. pylori strain 51 isolated in Korea produced most superior results. In conculsion, immunohistochemical staining taking account of local strains could contribute to improving the histological diagnosis of H. pylori
Objectives: In Asia, the use of antigens from local strains led to better sensitivity rates of the serological tests to detect the anti-Helicobacter pylori antibodies than the use of antigens from Western strains because of the regional variations in H. pylori antigenicity. However, these antigenic variations had not been evaluated in the immuno-histochemical examinations. This study was intended to investigate the comparisons of H. pylori detection among the classical staining methods like Hematoxylin and Eosin (H&E) stain, Warthin-Starry stain, and Giemsa stain, and the immunohistochemical staining methods using 3 different anti-H. pylori antibodies produced from geographically-not-related H. pylori strains . Especially, the focus was put to the difference in immunohistochemical staining depending on the antigenicities of strains, and the usability of the antibody produced from H. pylori strain 51 isolated in Korea. Methods: Using gastric endoscopy, biopsies were taken from antrum and corpus of the medical students of Gyeongsang National University in Korea, from 1997 to 2003. The gastric tissues of students whose urease test showed positive response within 1 hour underwent H&E staining, Warthin-Starry staining, Giemsa staining, and immunohisto-chemical staining with the rabbit antibodies to Helicobacter ATCC-43504 strain (Biodesign Ab), CH-20426 strain (Dako Ab), and H. pylori strain 51 (strain 51 Ab) were carried out. The grade of histopathological H. pylori densities were assessed into 0 to 6 on the basis of standard visual scale of Sydney system, by two observers independently. Grade differences were put to paired t-test, and inter-observer agreement were evaluated with gamma analysis. Results: There was difference in histopathological H. pylori grades according to staining methods. The histopathological H. pylori grades were the highest in Biodesign Ab and H. pylori strain 51 Ab produced higher histopathological H. pylori grades (P<0.001), and then Giemsa staining and Warthin-Starry staining in order. Dako Ab produced significantly lower grades, and H&E stains the lowest grade. Sensitivity was the highest in the H. pylori strain 51 Ab (96.21%, 99.31%). Biodesign Ab showed the sensitivity of 95.87%, 98.86%, Dako Ab 94.15%, 96.90%, and H&E staining 91.78%, 91.06%, the lowest. Inter-observer agreement was the highest in the H. pylori strain 51 Ab with 0.92. It was 0.87 in Biodesign Ab, 0.89 in Dako Ab, 0.88 in Warthin-Starry staining, and 0.74 in Giemsa staining. Conclusions: In the histological diagnosis of H. pylori, bacterial detection was different according to staining methods. Immunohistochemical staining methods also showed the highest H. pylori detection rate in this study. Three different anti-H. pylori antibodies produced different sensitivity in detection rate, different degree of histological H. pylori densities, and different inter-observer agreement. Immunohistochemical stains of the antibody to H. pylori strain 51 isolated in Korea produced most superior results. In conculsion, immunohistochemical staining taking account of local strains could contribute to improving the histological diagnosis of H. pylori
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