[Histonet] HELP!!!!! H. Pylori Immunos

[Jay Lundgren]

Our problem, in my opinion is a control issue and not a staining one..our
pathologist wants to see the bugs in certain areas-glands(spelling
appologies!) its called, the circular groups of cells, in the middle of
these areas and not just occasional bugs in other areas....Everywhere else
I've worked the pathologist would use a Diff-Quick, Cresyl Violet or Geimsa
in addition to the H&E,   I'm aware of other newer special stains for
H.Pylori that are out there, but this pathologist is firm on the IHC method
of choice.
I use NovaCastra polyclonal, incubation @23 min. HIER with low PH for 30
minutes.with  recommended detection kit..


     Heather,

      I hope you don't mind that I copied your email so that everyone on
this forum can learn from your question.  I always use the "Reply to All"
button so everyone can see my response.

     I was willing to bet before I read your query that we were dealing with
a control problem, not a staining problem.  I have seen some miserable
commercial *H. pylori* controls lately.  Some areas of the country are awash
in HP, some labs can't get a good positive control block of their own.  You
must first obtain a KNOWN POSITIVE CONTROL block. Stain slides from that
block with whichever chemical special stain is acceptable to your
Pathologist, I like a modified Warthin-Starry.  Sit down with your
Pathologist and evaluate the control slides.  Is it acceptable to the
Pathologist? If so, stain more slides from the positive control block, this
time immuno stain and chemical special stain in parallel.  Evaluate the
slides with the Pathologist.  Is there correlation between the chemical and
special stain?  If so, proceed, running your first 20 cases in parallel
(immuno and chemical special stains) and documenting (with the Pathologist's
signature) the correlation of your first 20 cases.

     If you are able to demonstrate HP with a chemical special stain, but
not with your immuno procedure, call your immuno vendor.

     If you are unable to demonstrate HP with a chemical special stain, it's
your control.  Or it could be your stain, but a Giemsa is pretty hard to
mess up.

Good Luck,



Jay A. Lundgren M.S., HTL (ASCP)