Proposal of a new diagnostic algorithm for Helicobacter pylori in histopathology: Hematoxylin-eosin and alkaline blue stain
In brief
A new Helicobacter pylori algorithm reached 95% specificity against routine staining
In 92 gastric biopsy samples, an algorithm combining routine and alkaline blue staining showed 93.5% sensitivity and 95.2% specificity compared with the conventional method; two experts also agreed closely on its results. The findings suggest a simpler, less toxic option for laboratories with limited access to specialized stains, but the conventional method served as the comparator, so validation against an independent reference is still needed.
- Journal
- Histology and histopathology (Q2)
- Published
- 5 October 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Gian Carlos Ramirez Ubillus, Mercedes Bravo Taxa, Renier Cruz Baca, Giancarlo Grandez Hidalgo, Dayana Manzo Pretel
- PMID
- 42831251
- DOI
- 10.14670/HH-25-148
Why clinicians should know about it
- Picked for Pathology and Forensic Medicine (top studies of the week, 11 October 2026): New H. pylori algorithm with high agreement
Abstract
OBJECTIVE: To determine the diagnostic capacity and interobserver agreement of a new diagnostic algorithm for Helicobacter pylori in histopathology compared with the current gold standard. METHODOLOGY: A cross-sectional study analyzed 92 paraffin blocks from gastric biopsies obtained from the Taxa Oncology Laboratory in Lima, Peru. Each block underwent three new sections, and Warthin-Starry staining, immunohistochemistry, and alkaline blue stain were applied. The results obtained by two experts and those from the conventional hematoxylin and eosin method were then grouped into two diagnostic algorithms and subsequently compared. RESULTS: As main results, the interobserver agreements of the new algorithm and the conventional method were K=0.90 (strong agreement) and K=0.85 (strong agreement), respectively. With adjusted Kappa, it was better for the new algorithm (K=0.91, almost perfect agreement) in comparison with the conventional one (K=0.87, strong agreement). Also, all diagnostic capacity statistics for the new algorithm compared with the conventional one (reference) were very high (sensitivity=93.5% and predictive positive value=90.3%), highlighting the specificity and predictive negative value (95.2% and 96.7%, respectively). CONCLUSION: This proposed new diagnostic algorithm presented optimal statistical reliability, in addition to being faster, less toxic, and easier to implement than the conventional one, which suggests it has great potential for application in pathology laboratories, especially for those who cannot afford reference methods, such as immunohistochemistry or Warthin-Starry.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.