[Histonet] H. pylori immunos on gastric biopsies
I've finally had a chance to compare two methods - our lab changed from
Giemsa (actually Diff-Quik II generic equivalent) to immunostaining a few months
ago.
It's a lot easier to find the bacteria with the immunostain than it is with
the dye technique, but bacterial morphology is not as good. If I were seeing 17
total cases a day with one gastric biopsy every other day, and had time to
search the slide with an oil immersion lens, I'd rather have the dye technique.
But when I have to sign out 60 cases in a day, with 10 gastric biopsies, I'd
rather have the immunostain.
Clinically, there are several ways to make the diagnosis: biopsy sections,
urease (Clo-Test) testing of a biopsy specimens, serology, isotopically labeled
urea with breath testing. Obviously as a pathologist I have my prejudices, but
there's nothing like tissue sections to pin down the diagnosis of chronic
active gastritis and make sure the patient doesn't have a lymphoma or carcinoma
lurking in there as well.
Bob Richmond
Gaston Memorial Hospital, Gastonia NC
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