Comparative Evaluation of Modified Giemsa and Warthin-Starry Stains for Helicobacter pylori Detection and Density Grading Using the Updated Sydney System

Authors

  • Rahman Firmansyah Department of Anatomical Pathology, Faculty of Medicine Hasanuddin University, Makassar, Indonesia. https://orcid.org/0009-0000-6300-2650
  • Upik Andriani Miskad Department of Anatomical Pathology, Faculty of Medicine Hasanuddin University, Makassar, Indonesia.
  • Muhammad Husni Cangara Department of Anatomical Pathology, Faculty of Medicine Hasanuddin University, Makassar, Indonesia. https://orcid.org/0000-0002-5160-8265
  • Syarifuddin Wahid Department of Anatomical Pathology, Faculty of Medicine Hasanuddin University, Makassar, Indonesia. Department of Anatomical Pathology, Wahidin Sudirohusodo Hospital, Makassar, Indonesia.
  • Juanita Juanita Department of Anatomical Pathology, Faculty of Medicine Hasanuddin University, Makassar, Indonesia. Department of Anatomical Pathology, Wahidin Sudirohusodo Hospital, Makassar, Indonesia.
  • Suryani Tawali Department of Public Health, Faculty of Medicine Hasanuddin University, Makassar, Indonesia. https://orcid.org/0000-0002-2008-469X
  • Amalia Yamin Department of Anatomical Pathology, Faculty of Medicine Hasanuddin University, Makassar, Indonesia. Department of Anatomical Pathology, Wahidin Sudirohusodo Hospital, Makassar, Indonesia.

Keywords:

Modified Giemsa, Warthin-Starry, Detection, Density, Update Sydney System

Abstract

Objective: Helicobacter pylori is one of the main causes of chronic gastritis, gastric ulcers, and stomach cancer. Accurate diagnosis of H. pylori infection is essential for effective treatment and prevention.

Methods: This research is an analytical observational study with a cross-sectional retrospective design that aims to compare histochemical special stains, Modified Giemsa, and Warthin-Starry for H. pylori Detection and Density Grading using the Updated Sydney System in 150 gastric biopsies of Chronic Gastritis at the Department of Anatomical Pathology, Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia.

Result: There was a significant difference in detection of H. pylori (p=0.001), Warthin-Starry detected more H. pylori positive 111 samples (74.00%) than Modified Giemsa positive 95 samples (63.30%) and there was a significant difference in Density Grading using the Updated Sydney System (p=0.001), Warthin-Starry staining showed a higher density score of Grade 2 (moderate) with 63 samples (42.00%), compared to Modified Giemsa, the most dominant density score of Grade 1 (mild) with 61 samples (40.70%).

Conclusion: Warthin-Starry detects more H. pylori compared to Modified Giemsa. Additionally, the Warthin-Starry yields higher Density Grading using the Updated Sydney System for Grade 2 (Moderate) compared to the Modified Giemsa, with a dominant grade at Grade 1 (Mild) in chronic gastritis. This highlights the importance of selecting the most appropriate histochemical staining method for accurate early diagnosis, where resource limitations restrict the use of advanced diagnostic modalities that may not be routinely available.

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Published

2025-11-26

Issue

Vol. 10 No. 4 (2025)

Section

Research Articles/ Original Work

License

 West Asia Organization for Cabcer Prevention retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License 4 (This permits anyone to copy, distribute, transmit and adapt the published work, provided the original work and source are appropriately cited).