alcian-blue and Helicobacter-Infections

Barrett's esophagus is a common pathological condition in patients with gastro-esophageal reflux disease.. The aim of this study was to compare endoscopic diagnosis versus histological confirmation.. Cross-sectional.. Cancer Institute of the Imam Khomeini Hospital.. A total of 50 patients with a history of gastro-esophageal reflux were recruited and underwent upper endoscopy at this cross-sectional survey. Four-quadrant biopsy was taken from all suspected areas of intestinal metaplasia. Sections of blocks were stained with Mixed Alcian Blue (PH 2.5)/PAS and haematoxylin-eosin stainings for the diagnosis of intestinal metaplasia (complete vs. incomplete types) and goblet cell / columnar cell / dysplasia, respectively.. The presence of Helicobacter pylori was assessed by Giemsa staining.. There were 44 cases of short-segment Barrett's esophagus and 6 of long-segment Barretts esophagus by endoscopy. When examined by histologic examination, 12 patients with short-segment Barrett's esophagus and 4 with long-segment Barrett's esophagus had intestinal metaplasia. Haematoxylin-eosin staining diagnosed 12 cases of intestinal metaplasia, whereas mixed alcian blue/PAS was used to diagnose 16 cases (κ = 80%, p < 0.001). The positive predictive value in the diagnosis of goblet cell metaplasia and columnar cell metaplasia was 32% and 66%, respectively. Helicobacter pylori infection was observed in 10 cases of those with columnar cell metaplasia without goblet cells, while none of the patients with intestinal metaplasia were infected.. Our findings suggest that biopsy taking is necessary in all patients with gastro-esophageal reflux disease, whose results suggest columnar cell lining in distal esophagus in endoscopy.

Topics: Alcian Blue; Barrett Esophagus; Biopsy; Cross-Sectional Studies; Esophagoscopy; Esophagus; Female; Gastritis; Gastroesophageal Reflux; Helicobacter Infections; Humans; Male; Metaplasia; Middle Aged; Periodic Acid-Schiff Reaction; Predictive Value of Tests

The purpose of this study was to evaluate the role of the mixture of carbol fuchsin and alcian blue stain in the diagnosis of Helicobacter pylori (HP) and goblet cell intestinal metaplasia (IM) in comparison to the more commonly used Giemsa and hematoxylin and eosin (H&E) stains. Pathological blocks of gastric tissues obtained from January 2006 to December 2007 were recut and processed for Giemsa and a mixture of carbol fuchsin and alcian blue stains. Clinical data regarding the patients were collected and previous slides stain with H&E from gastric tissues were reviewed. The Giemsa and the mixture of carbol fuchsin and alcian blue stains were studied by a pathologist who was blinded to the pathological and clinical data. Direct comparisons were made between the stains for diagnosis of HP. Of 423 cases studied the concordance rate was 97.8% (kappa value=0.947, p< 0.05). Using the mixture of carbol fuchsin and alcian blue stain, 4.3 % of goblet cell IM which were not detected by H&E stain were additionally identified. The prevalences of HP infection diagnosed by Giemsa, the mixture of carbol fuchsin and alcian blue, and H&E stains were 72.1%, 72.3%, and 71%, respectively. In conclusion, the mixture of carbol fuchsin and alcian blue stain can be used in place of Giemsa stain for the identification of HP, and is probably preferable because of its low cost and is less time-consuming. Carbol fuchsin and alcian blue which are commonly available dyes are more beneficial than Giemsa stain and aid in identifing goblet cell IM undiagnosed by conventional H&E stain.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alcian Blue; Biopsy; Female; Goblet Cells; Helicobacter Infections; Helicobacter pylori; Humans; Intestinal Diseases; Male; Metaplasia; Middle Aged; Rosaniline Dyes; Staining and Labeling

Helicobacter pylori and intestinal metaplasia (IM) are readily seen in hematoxylin and eosin-stained slides of gastric and/or esophageal biopsies, yet many pathology laboratories perform routine special stains on all of these biopsies. We wished to determine if special stains are necessary for every single gastric and/or esophageal biopsy. We prospectively studied 613 gastric and/or esophageal biopsies from 494 consecutive patients. The slides were stained with hematoxylin and eosin, toluidine blue (TB) for H. pylori, and Alcian blue (AB) for IM. The hematoxylin and eosin slide was classed as positive or negative for H. pylori and IM. Then it was determined if the case needed a TB or AB stain. A total of 436 cases (71.1%) were identified as H. pylori-negative and not needing a TB stain, and none was TB+. A total of 126 (20.6%) of hematoxylin and eosin slides were inconclusive for H. pylori and were regarded as needing a TB stain. Twenty of these (15.9%) were TB+. Fifty-one biopsies (8.3%) were regarded as H. pylori+ on hematoxylin and eosin; the TB stain was also positive in 49. IM was present in 113 (18.4%) hematoxylin and eosin biopsies. Hematoxylin and eosin slides were IM-negative in 498 cases (81.2%). The AB stain revealed rare goblet cells in 3 of 498 cases (0.6%). Only one of those biopsies was esophageal, and that had one goblet cell that was missed on hematoxylin and eosin. Only 2 (0.3%) were regarded as needing an AB stain. We conclude that routine special stains for all gastric and/or esophageal biopsies are not required, and hematoxylin and eosin assessment combined with selective ordering of these stains will identify virtually all cases of H. pylori gastritis and intestinal metaplasia.

Topics: Alcian Blue; Biopsy; Eosine Yellowish-(YS); Esophagus; Helicobacter Infections; Helicobacter pylori; Hematoxylin; Humans; Metaplasia; Staining and Labeling; Stomach; Tolonium Chloride

Topics: Alcian Blue; Bacterial Typing Techniques; Coloring Agents; Eosine Yellowish-(YS); Helicobacter Infections; Helicobacter pylori; Hematoxylin; Humans; Rosaniline Dyes; Staining and Labeling

To study the prevalence of peptic ulcer and the histological appearance of the gastric mucosa in healthy, asymptomatic Indians infected with Helicobacter pylori.. Asymptomatic, healthy individuals without any GI symptoms were invited to undergo endoscopy of the upper GI tract. A careful search was made for any erosion or ulcer. Four biopsy specimens were obtained from the gastric corpus and antrum. Histological sections were stained with hematoxylin and eosin for histological details and with Loffler's methylene blue for the presence of H. pylori. Alcian blue periodic acid-Schiff stain (pH 2.5) was used to classify and grade areas of intestinal metaplasia.. Histological examination showed chronic gastritis in 72 (80%) persons. Pangastritis was seen in 22% of subjects; pangastritis with antral predominance, in 28%; and antrum-only gastritis, in 50%. Activity was noted in biopsy specimens from only 33% of the subjects. H. pylori infection was present in 70 (78%) subjects. All of these subjects had evidence of chronic gastritis. Endoscopic examination revealed a normal appearance in 88 individuals. In two individuals a duodenal ulcer was seen. Both subjects had severe H. pylori infection in the antral mucosa. Of the 70 persons having H. pylori infection, only two (2.8%) had a duodenal ulcer.. This study showed that despite a high prevalence of H. pylori infection in asymptomatic, healthy Indians, the point prevalence of peptic ulcer is low, and chronic active gastritis is uncommon.

Topics: Adolescent; Adult; Aged; Alcian Blue; Biopsy; Chronic Disease; Coloring Agents; Duodenal Ulcer; Eosine Yellowish-(YS); Female; Fluorescent Dyes; Gastric Mucosa; Gastritis; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Hematoxylin; Humans; India; Intestinal Mucosa; Male; Metaplasia; Methylene Blue; Middle Aged; Periodic Acid-Schiff Reaction; Prevalence; Pyloric Antrum; Stomach Diseases; Stomach Ulcer

Signet ring cell carcinoma is a poorly differentiated adenocarcinoma in which the tumour cells invade singly or in small groups. Early stages of the disease can be missed easily when using regular haematoxylin and eosin staining. This is a report of a case in which routine screening of gastric biopsies with the Genta stain was responsible for rapid identification of signet ring carcinoma. The patient, a 29 year old woman, had a large portion of the antrum excised surgically for signet ring cell gastric carcinoma. Follow up endoscopy six years later showed no evidence of tumour. Twenty six large cup biopsies were obtained and a single focus of signet ring tumour cells infiltrating the surface mucosa in single files was seen. The diagnosis was missed on haematoxylin and eosin stain by three senior pathologists but owing to the Alcian blue component of the Genta stain the tumour cells were recognised easily. Thus, the Genta stain not only facilitates detection of Helicobacter pylori but also allows for simultaneous visualisation of gastric morphology as well as signet ring carcinoma that can be missed with conventional stains.

Topics: Adult; Alcian Blue; Carcinoma, Signet Ring Cell; Coloring Agents; Female; Helicobacter Infections; Helicobacter pylori; Humans; Stomach Neoplasms

To elucidate the role of Helicobacter pylori infection in the pathogenesis of gastric ulcer, we investigated the intracellular mucin content by measuring the periodic acid-Schiff-Alcian blue (PAS-AB)-stained substances, by means of computer, in the biopsy sample of gastric mucosa from patients with and without H. pylori infection. In the antral mucosa the intracellular PAS-AB-stained mucin content was significantly smaller in patients with infection than in patients without infection, whereas in the oxyntic gland mucosa the intracellular mucin content showed no significant change between patients with and without infection. In an animal study we investigated the effect of ammonia, which might be produced by H. pylori in the presence of urea. The ammonia, administered orally, caused a greater decrease of intracellular PAS-AB-stained mucin content in the gastric antral mucosa than in the body mucosa, in a dose-dependent manner. The results suggested that H. pylori infection had a different effect on the gastric mucosal intracellular PAS-AB-stained mucin and lowered specifically the antral intracellular PAS-AB-stained mucin content, possibly due to generation of ammonia by H. pylori.

Topics: Alcian Blue; Ammonia; Analysis of Variance; Animals; Gastric Fundus; Gastric Mucins; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Male; Periodic Acid-Schiff Reaction; Pyloric Antrum; Rats; Rats, Inbred Strains; Stomach Ulcer