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Histopathologic Diagnosis of H. pylori Infection and Associated Gastric Diseases

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Helicobacter pylori

Abstract

Helicobacter pylori (H. pylori) can be diagnosed by histopathologic examination which is considered to be a standard method, since not only it observes H. pylori directly but also it evaluates the degree of gastric inflammation, gastritis-related intestinal metaplasia, atrophic gastritis, and tumor. Among various staining methods, hematoxylin and eosin (H&E) stain is a routine procedure in daily practice. However, if H&E stain is not enough for histological diagnosis, ancillary tests including special staining and immunohistochemistry (IHC) are needed for accurate diagnosis. Among various ancillary tests, Giemsa stain has high sensitivity, and silver stain and IHC have high sensitivity and specificity. The initial stage of H. pylori infection is mostly asymptomatic, but it can develop into acute and chronic gastritis. H. pylori-related chronic gastritis shows not only lymphocyte and plasma cell infiltration but also neutrophil infiltration inside epithelium. H. pylori-related chronic gastritis can lead to sequelae, such as atrophic gastritis, intestinal metaplasia, and lymphoid follicles. Moreover, H. pylori infection is a cause of mucosa-associated lymphoid tissue (MALT) lymphoma and gastric cancer, and especially the infection has a close relationship with extranodal marginal zone B lymphoma of MALT and intestinal-type gastric adenocarcinoma. Therefore, histopathologic diagnosis is necessary for gastritis patients, and it should include the degree of gastritis and the presence of H. pylori, sequela of gastritis, and malignant tumor.

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References

  1. McColl KE. Clinical practice. Helicobacter pylori infection. N Engl J Med. 2010;362:1597–604.

    Article  CAS  PubMed  Google Scholar 

  2. International Agency for Research on Cancer, World Health Organization. Infection with Helicobacter pylori. In: Schistosomes, liver flukes and Helicobacter pylori. Lyon: IARC Monogr Eval Carcinog Risks Hum; 1994. p. 177–240.

    Google Scholar 

  3. Basset C, Holton J, Ricci C, Gatta L, Tampieri A, Perna F, et al. Review article: diagnosis and treatment of Helicobacter: a 2002 updated review. Aliment Pharmacol Ther. 2003;17 Suppl 2:89–97.

    Article  PubMed  Google Scholar 

  4. Rautelin H, Lehours P, Mégraud F. Diagnosis of Helicobacter pylori infection. Helicobacter. 2003;8 Suppl 1:13–20.

    Article  CAS  PubMed  Google Scholar 

  5. Laine L, Lewin DN, Naritoku W, Cohen H. Prospective comparison of H&E, Giemsa, and Genta stains for the diagnosis of Helicobacter pylori. Gastrointest Endosc. 1997;45:463–7.

    Article  CAS  PubMed  Google Scholar 

  6. Fallone CA, Loo VG, Lough J, Barkun AN. Hematoxylin and eosin staining of gastric tissue for the detection of Helicobacter pylori. Helicobacter. 1997;2:32–5.

    Article  CAS  PubMed  Google Scholar 

  7. El-Zimaity HM, Segura AM, Genta RM, Graham DY. Histologic assessment of Helicobacter pylori status after therapy: comparison of Giemsa, Diff-Quik, and Genta stains. Mod Pathol. 1998;11:288–91.

    CAS  PubMed  Google Scholar 

  8. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996;20:1161–81.

    Article  CAS  PubMed  Google Scholar 

  9. el-Zimaity HM, Wu J, Akamatsu T, Graham DY. A reliable method for the simultaneous identification of H. pylori and gastric metaplasia in the duodenum. J Clin Pathol. 1999;52:914–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Genta RM, Robason GO, Graham DY. Simultaneous visualization of Helicobacter pylori and gastric morphology: a new stain. Hum Pathol. 1994;25:221–6.

    Article  CAS  PubMed  Google Scholar 

  11. Doglioni C, Turrin M, Macri E, Chiarelli C, Germanà B, Barbareschi M. HpSS: a new silver staining method for Helicobacter pylori. J Clin Pathol. 1997;50:461–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Mendoza ML, Martín-Rabadán P, Carrión I, Morillas JD, López-Alonso G, Diaz-Rubio M. Helicobacter pylori infection. Rapid diagnosis with brush cytology. Acta Cytol. 1993;37:181–5.

    CAS  PubMed  Google Scholar 

  13. Seo TH, Lee SY, Uchida T, Fujioka T, Jin CJ, Hwang TS, et al. The origin of non-H. pylori-related positive Giemsa staining in human gastric biopsy specimens: a prospective study. Dig Liver Dis. 2011;43:23–7.

    Article  PubMed  Google Scholar 

  14. Jonkers D, Stobberingh E, de Bruine A, Arends JW, Stockbrügger R. Evaluation of immunohistochemistry for the detection of Helicobacter pylori in gastric mucous membrane biopsies. J Infect. 1997;35:149–54.

    Article  CAS  PubMed  Google Scholar 

  15. Andersen LP, Rasmussen L. Helicobacter pylori-coccoid forms and biofilm formation. FEMS Immunol Med Microbiol. 2009;56:112–5.

    Article  CAS  PubMed  Google Scholar 

  16. Riddell R, Jain D. Lewin, Weinstein and Riddell’s gastrointestinal pathology and its clinical implications. 2nd ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014.

    Google Scholar 

  17. Rugge M, Correa P, Dixon MF, Fiocca R, Hattori T, Lechago J, et al. Gastric mucous membrane atrophy: interobserver consistency using new criteria for classification and grading. Aliment Pharmacol Ther. 2002;16:1249–59.

    Article  CAS  PubMed  Google Scholar 

  18. Rugge M, Correa P, Di Mario F, El-Omar E, Fiocca R, Geboes K, et al. OLGA staging for gastritis: a tutorial. Dig Liver Dis. 2008;40:650–8.

    Article  CAS  PubMed  Google Scholar 

  19. Filipe MI, Muñoz N, Matko I, Kato I, Pompe-Kirn V, Jutersek A, et al. Intestinal metaplasia types and the risk of gastric cancer: a cohort study in Slovenia. Int J Cancer. 1994;57:324–9.

    Article  CAS  PubMed  Google Scholar 

  20. Rokkas T, Filipe MI, Sladen GE. Detection of an increased incidence of early gastric cancer in patients with intestinal metaplasia type III who are closely followed up. Gut. 1991;32:1110–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Liu Q, Teh M, Ito K, Shah N, Ito Y, Yeoh KG. CDX2 expression is progressively decreased inhuman gastric intestinal metaplasia, dysplasia and cancer. Mod Pathol. 2007;20:1286–97.

    Article  CAS  PubMed  Google Scholar 

  22. Miyamoto M, Haruma K, Yoshihara M, Hiyama T, Sumioka M, Nishisaka T, et al. Nodular gastritis in adults is caused by Helicobacter pylori infection. Dig Dis Sci. 2003;48:968–75.

    Article  PubMed  Google Scholar 

  23. Hassall E, Dimmick JE. Unique features of Helicobacter pylori disease in children. Dig Dis Sci. 1991;36:417–23.

    Article  CAS  PubMed  Google Scholar 

  24. Hayashi S, Imamura J, Kimura K, Saeki S, Hishima T. Endoscopic features of lymphoid follicles in Helicobacter pylori-associated chronic gastritis. Dig Endosc. 2015;27:53–60.

    Article  PubMed  Google Scholar 

  25. Wotherspoon AC, Ortiz-Hidalgo C, Falzon MR, Isaacson PG. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet. 1991;338:1175–6.

    Article  CAS  PubMed  Google Scholar 

  26. Sumida T, Kitadai Y, Hiyama T, Shinagawa K, Tanaka M, Kodama M, et al. Antibodies to Helicobacter pylori and CagA protein are associated with the response to antibacterial therapy in patients with H. pylori-positive API2-MALT1-negative gastric MALT lymphoma. Cancer Sci. 2009;100:1075–81.

    Article  CAS  PubMed  Google Scholar 

  27. Tan D, Lauwers GY. Advances in surgical pathology: gastric cancer. 1 Har/Psc ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011.

    Google Scholar 

  28. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification. Acta Pathol Microbiol Scand. 1965;64:31–49.

    CAS  PubMed  Google Scholar 

  29. Bosman FT, Carneiro F, Hruban RH, Theise ND. The International Agency for Research on Cancer. WHO classification of tumours of the digestive system. 4th ed. Lyon: IARC Press; 2010.

    Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, Gyeonggi-do, 13620, South Korea

    Hye Seung Lee MD, PhD

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  1. Hye Seung Lee MD, PhD
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Correspondence to Hye Seung Lee MD, PhD .

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  1. Seoul National University, Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (Republic of)

    Nayoung Kim

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Lee, H.S. (2016). Histopathologic Diagnosis of H. pylori Infection and Associated Gastric Diseases. In: Kim, N. (eds) Helicobacter pylori. Springer, Singapore. https://doi.org/10.1007/978-981-287-706-2_9

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  • DOI: https://doi.org/10.1007/978-981-287-706-2_9

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