There are four broad choices for staining Helicobacter. 1. Rely on H & E alone. Some people claim it works, but I can't find them unless they're all over the place.
2. Thiazine dye methods. The simplest is the blue dye mix Diff-Quik II (or a generic equivalent, all of which work in my experience), the next a Giemsa stain, and it's possible to complicate them considerably more. 3. Silver stains such as Steiner's. They work, but they're a lot of trouble and the tissue often falls off the slide. I have almost no experience with them. 4. Immunostains. More expensive to do, but a lot faster for the pathologist to read. I haven't seen a study comparing the sensitivity of these methods. My personal opinion is that I'm OK with Diff-Quik II if I'm seeing one gastric biopsy a day, but I want IHC if I'm going to be seeing ten of them. With the dye method I often have to resort to oil immersion magnification, where with IHC I barely need to use a high-dry lens. **************************************** Helicobacter controls: Not really necessary, but should be done anyway. You need the co-operation of your pathologist in finding positives suitable for use as controls. One gastrectomy specimen can of course set you up for life, but these are pretty rare these days. Some additional points: many pathologists don't understand that not all bacteria they see in the stomach are Helicobacter - morphologic criteria must be observed. (IHC gets around this problem.) There is another, rather rare Helicobacter that causes peptic ulcer disease, with different morphology (a tight corkscrew rather than a "gull wing") - Helicobacter heilmanii. Supposedly IHC picks it up. There's controversy as to whether all gastric biopsy specimens need a stain of some kind, or only the ones with acute inflammation (confusingly called chronic active gastritis). Bob Richmond Samurai Pathologist Maryville TN _______________________________________________ Histonet mailing list Histonet@lists.utsouthwestern.edu http://lists.utsouthwestern.edu/mailman/listinfo/histonet