[Histonet] Re: question on H pylori

[Robert Richmond]

On the question of staining Helicobacter pylori:

There is no "standard of care" (remember that "standard of care" is a
term of art and should not be used casually) for staining
Helicobacter. As far as I know, nobody has ever done a study comparing
the efficacy of the various staining methods.

Blue stains (usually called Giemsa) may still be most commonly used.
The blue component of Diff-Quik (Diff-Quik II - any generic equivalent
will do) suffices and is much simpler to do. Some labs that do their
own preparation make a suitably buffered solution of toluidine blue.

Many labs have gone to immunostaining. This decision needs to be made
partly on reimbursement considerations, particularly if you're going
to outsource the staining and have your pathologist read the slides. -
Worthwhile knowing that the rare (I've seen it once) Helicobacter
heilmanii immunostains as well as does Helicobacter pylori.

I haven't seen silver stains (Steiner, Warthin-Starry) in use for
quite a few years. They are so difficult to do that I can't imagine
anyone still using them.

My personal preference is a blue stain if I have only one slide a day
to read, but IHC if I have ten - IHC can be read much faster with much
less magnification.

An interesting new development for IHC is virtual slide technology -
Genzyme (I have no connection with Genzyme) does the IHC and uploads a
virtual slide, which the pathologist interprets. One associate of mine
finds this highly satisfactory - I find it slow and cumbersome and I'm
never sure I've seen the whole slide. (I have some vision issues with
it - remember I'm 72 years old and quite nearsighted.)

Bob Richmond
Samurai Pathologist
Knoxville TN