A TRIPLE STAIN FOR THE DETECTION OF HELICOBACTER-PYLORI GASTRIC BRUSHING CYTOLOGY

OBJECTIVE: Helicobacter pylori is a surface bacterium associated with gastritis. The triple stain (TS), combining silver, hematoxylin and eo sin, and alcian blue at pH 2.5, is valuable in the detection of H pylo ri in tissue. We evaluated the usefulness of TS as compared with Papan icolaou stain in detecting H pylori in gastric brushings and biopsy sp ecimens. STUDY DESIGN: Gastric brushings and biopsy specimens were obt ained from 21 patients. The Papanicolaou-stained slides were restained with TS, and the brushings and biopsy specimens were independently ev aluated by the authors. RESULTS: H pylori was found in 9 of 21 randoml y selected cases using TS. Of these, two cases were positive on brushi ngs alone and three on biopsy alone. Only three of the Mine cases were positive by Papanicolaou stain. None of the 21 samples were positive with Papanicolaou stain yet negative with TS. Detection of H pylori wa s restricted to patients with gastric ulcerations but was not limited by paucity of glands. CONCLUSION: TS is useful for detecting H pylori in gastric brushings and provides excellent cytologic detail. Furtherm ore, TS is superior to Papanicolaou stain for H pylori detection and i s a valuable adjunct to biopsy.