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A comparative study between hematoxylin and eosin and immunohistochemistry in patients with chronic gastritis and gastric adenocarcinoma in Erbil City, Iraq

Dlzar Badeea Khwada
Department of Medical Microbiology, College of Health Science, Hawler Medical University, Erbil, Kurdistan Region, Iraq
Tavga Hushiar Salim
Department of Medical Microbiology, College of Health Science, Hawler Medical University, Erbil, Kurdistan Region, Iraq
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Copyright (c) 2026 Dlzar Badeea Khwada, Tavga Hushiar Salim (Author)

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Abstract

Backgroundand objective: Helicobacter pylori infection is the most common and treatable cause of chronic gastritis; it is strongly linked to peptic ulcer, low-grade gastric lymphoma, and adenocarcinoma. Infection with this microorganism affects more than half the world's population.The research aimed to compare sensitivity, specificity, and positive predictive value between two histopathological methods, hematoxylin and eosin (H&E) and immunohistochemistry (IHC), in patients with chronic gastritis and gastric cancer.

Methods: A total of 90 gastric biopsies were included in the study — 44 with chronic gastritis and 46 diagnosed with gastric adenocarcinoma — collected from the archive of the Histopathology Department at Erbil International Private Hospital between January 2024 and January 2025. Slides were stained with H&E, and IHC staining was performed using a polyclonal anti-H. pylori antibody. Sensitivity, specificity, and positive predictive value were calculated.

Results: More than two-thirds of cancer patients (67.4%) were aged ≥ 60 years, compared to 38.6% of the gastritis group (p = 0.012). More than half (52.2%) of cancer patients were male, compared with 43.2% of patients with gastritis. The two diagnostic techniques revealed a statistically significant difference (p = 0.035); the H&E stain showed 50% sensitivity, 46.9% specificity, and 47.7% overall agreement with IHC.

Conclusion: IHC staining is more accurate for determining Helicobacter pylori infection than the traditional H&E stain, especially in equivocal samples with a low bacterial load and inactive gastritis. IHC showed the highest sensitivity, specificity, and inter-observer agreement compared with H&E stain.

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How to Cite
Badeea Khwada, D. ., & Hushiar Salim, T. . (2026). A comparative study between hematoxylin and eosin and immunohistochemistry in patients with chronic gastritis and gastric adenocarcinoma in Erbil City, Iraq. Zanco Journal of Medical Sciences (ZJMS), 615–623. https://doi.org/10.15218/zjms.2026.042

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