The Immunohistochemical Stain for Detecting Helicobacter pylori after Eradication Therapy

Hong, Su Jin; Kwak, Jeong Ja; Park, Yong Ju; Kim, Young Tae; Kim, Jin Oh; Cho, Joo Young; Lee, Joon Seong; Lee, Moon Sung; Lee, Dong Wha; Shim, Chan Sup

Abstract

BACKGROUND/AIMS: Accurate detection of Helicobacter pylori is essential to confirm eradication of H. pylori after treatment. The purpose of this study was to evaluate usefulness of the immunohistochemical stain in detecting H. pylori after eradication treatment.
METHODS
Gastroscopy for biopsy sampling was performed on 89 patients with peptic ulcer disease. Antral biopsy specimens were taken from antrum and corpus (five specimens from each) for rapid urease test, histological examination, polymerase chain reaction (PCR), and culture. All patients with H. pylori were treated with omeprazole, amoxicillin, and clarithromycin for two weeks and then, endoscopy and tests for detecting H. pylori were performed four weeks after completion of eradication therapy.
RESULTS
The H. pylori- infected patients were 65 of the 89 patients and they were treated with the eradication therapy. According to repeated endoscopy for 46 of the 65 patients, H. pylori was still detected as follows: 1 patient (2.2%) by CLO test; 2 (4.4%) by culture; 7 (15.2%) by PCR; 3 (6.5%) by H&E stain; 10 (21.7%) by Genta-Robason stain; 12 (26.0%) by immunohistochemical stain. Coccoid forms of H. pylori were identified in 6 cases, and all of them were detected only by immunohistochemical stain.
CONCLUSIONS
The immunohistochemical stain was a sensitive method for detecting H. pylori in gastric biopsy specimens after eradication therapy, especially for detecting coccoid forms of H. pylori.