Comparison of tissue staining between trial and routine stain (V1)
Research type
Research Study
Full title
Adapting to change-Alterations to Helicobacter Pylori demonstration stains for better diagnosis using digital pathology
IRAS ID
308106
Contact name
Donna Horncastle
Contact email
Sponsor organisation
InHealth Pathology
Duration of Study in the UK
0 years, 9 months, 31 days
Research summary
Within Histology, there has been an evolution towards reporting cases from high-resolution images of slides rather than microscopy, allowing for greater ease of reporting and sharing of cases should a second opinion be needed. This has however led to setbacks in reporting due to the nature of these images, such as the reporting of H. Pylori infections in gastritis. Normally, a consultant could focus in and out of the optimum plane of resolution down a microscope to see the microorganisms, due to them being far smaller than human cells and so can be easily either above or below the optimum plane of resolution for the rest of the tissue, given that the scanner will focus on the best plane for the human cells. Since slide scanners scan only in the optimum plane of resolution, this means they can be missed. This is further compounded by the most common stain for their identification (Modified Giemsa stain) staining the microorganisms blue on a background of blue, causing them to sometimes appear as detritus in the images. The gold standard of H. Pylori identification is immunohistochemical techniques, but this method is long, and can be costly in the long run if used just for screening, as every gastritis case would likely need this stain, and so is not universally used. Similarly, other good contrasting techniques exist (e.g., Alcian yellow toluidine blue technique) but the cost of the reagents makes standard use unattractive. I plan to trial an amalgamation of two staining techniques (Periodic Acid Schiff’s and Toluidine blue) to make H. Pylori easier to identify in sections, the microorganisms appearing blue on a background of pink, allowing for greater ease of identification and quicker treatment plan decisions for patients at a fraction of the cost of the other techniques.
REC name
North of Scotland Research Ethics Committee 2
REC reference
22/NS/0142
Date of REC Opinion
7 Dec 2022
REC opinion
Further Information Favourable Opinion