array:23 [ "pii" => "S1699885523000442" "issn" => "16998855" "doi" => "10.1016/j.patol.2023.05.002" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "737" "copyright" => "Sociedad Española de Anatomía Patológica" "copyrightAnyo" => "2023" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Patol. 2023;56:219-26" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S1699885523000466" "issn" => "16998855" "doi" => "10.1016/j.patol.2023.05.003" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "738" "copyright" => "Sociedad Española de Anatomía Patológica" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Patol. 2023;56:227-32" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "The value of SOX10 expression in predicting perineural invasion in gastric cancer" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "227" "paginaFinal" => "232" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El valor de la expresión de SOX10 en la predicción de la invasión perineural en el cáncer gástrico" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1088 "Ancho" => 1207 "Tamanyo" => 347094 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Histopathological examination showed gastric adenocarcinoma (left) and SOX10 positivity staining by IHC in perineural invasion by malignant cells (right). (Tumoral cells are indicated by arrow).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Seyed Amir Miratashi Yazdi, Atieh Moghtadaie, Elham Nazar" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Seyed Amir Miratashi" "apellidos" => "Yazdi" ] 1 => array:2 [ "nombre" => "Atieh" "apellidos" => "Moghtadaie" ] 2 => array:2 [ "nombre" => "Elham" "apellidos" => "Nazar" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699885523000466?idApp=UINPBA00004N" "url" => "/16998855/0000005600000004/v1_202310250520/S1699885523000466/v1_202310250520/en/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S169988552300051X" "issn" => "16998855" "doi" => "10.1016/j.patol.2023.09.001" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "741" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "edi" "cita" => "Rev Esp Patol. 2023;56:217-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "JUNTOS, FORMAMOS UN GRAN EQUIPO, LA SEAP!!" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "217" "paginaFinal" => "218" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "TOGETHER, WE FORM A GREAT TEAM, THE SEAP!" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Santiago Ramón, Cajal Agüeras" "autores" => array:2 [ 0 => array:3 [ "preGrado" => "Dr." "nombre" => "Santiago" "apellidos" => "Ramón" ] 1 => array:2 [ "nombre" => "Cajal" "apellidos" => "Agüeras" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S169988552300051X?idApp=UINPBA00004N" "url" => "/16998855/0000005600000004/v1_202310250520/S169988552300051X/v1_202310250520/es/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Initial assessment of “Gissell's stain”: A novel histopathological method for the identification of <span class="elsevierStyleItalic">Helicobacter pylori</span>" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "219" "paginaFinal" => "226" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Gian Carlos Ramirez Ubillus, Mercedes Bravo Taxa, Renier Cruz Baca, Ricardo Neira Montoya, Eduardo Sedano Gelvet" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Gian Carlos" "apellidos" => "Ramirez Ubillus" "email" => array:1 [ 0 => "gian.ramirez@upsjb.edu.pe" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Mercedes" "apellidos" => "Bravo Taxa" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "Renier" "apellidos" => "Cruz Baca" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Ricardo" "apellidos" => "Neira Montoya" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "Eduardo" "apellidos" => "Sedano Gelvet" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Escuela de Tecnología Médica, Universidad Privada San Juan Bautista, Lima, Peru" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Laboratorio Oncológico Taxa, Lima, Peru" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Instituto Nacional de Enfermedades Neoplásicas, Servicio de Anatomía Patológica, Lima, Peru" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Hospital María Auxiliadora, Servicio de Anatomía Patológica, Lima, Peru" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Valoración inicial de la tinción de Gissell, un nuevo método histopatológico en la identificación del <span class="elsevierStyleItalic">Helicobacter pylori</span>" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1023 "Ancho" => 1813 "Tamanyo" => 290708 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Presence of <span class="elsevierStyleItalic">Helicobacter pylori</span> by each staining method (40×). (A) Haematoxylin–eosin. (B) Giemsa. (C) “Gissell's stain”.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Helicobacter pylori</span> is a gram-negative, spiral-shaped bacterium, whose main behaviour in humans is the colonization of the gastric epithelium.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> Its presence is considered a risk factor for the development of adenocarcinoma, the most common gastric cancer (occurring in up to 90% of patients).<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In most laboratories, the final diagnosis is confirmed by histopathological methods using haematoxylin–eosin (HE) as the routine staining method as not only can it identify the bacteria, but also reveal other coexisting gastric pathologies.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">3</span></a> However, often the bacteria do not stain well, so the sensitivity (SE) is usually much lower than the specificity (SP) for this method (SE: 44.7–83%, SP: 75–100%).<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">4–8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">There are methods with better SE and SP, such as immunohistochemistry (SE: 97–98.8%, SP: 99.2–100%) and silver impregnations (SE: 62–97%, SP: 85.7–98%),<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">7,9–11</span></a> but these are expensive and have extensive and complex protocols and are not available in most laboratories. The Giemsa staining method is frequently used to confirm doubtful cases because it is economical and its SE (62–92.1%) and SP (88.8–100%)<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">4–8</span></a> are close to those of the most reliable methods. Moreover, Giemsa protocols are heterogeneous (especially for staining time), which affects the reproducibility of the results. Furthermore, one single test is not currently considered sufficient as the Gold Standard (GS) for identifying <span class="elsevierStyleItalic">H. pylori</span>. Therefore, the European Helicobacter Pylori Study Group (EHPSG) recommends that at least two positive tests should be applied as a reference algorithm, with an emphasis on invasive tests.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> However, in routine practice and in most reports, this recommendation is not considered, which makes the results reported questionable.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Therefore, a new staining method for the identification of <span class="elsevierStyleItalic">H. pylori</span> is required to overcome these limitations. The main objective of this study was to evaluate the diagnostic capacity and inter-observer agreement of “Gissell's stain”.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study design and setting</span><p id="par0025" class="elsevierStylePara elsevierViewall">Cross-sectional research was conducted in Taxa Oncological Laboratory, Lima, Peru, from January to April 2022.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study population and sample</span><p id="par0030" class="elsevierStylePara elsevierViewall">725 gastric paraffin blocks from Taxa Oncological Laboratory during 2020.</p><p id="par0035" class="elsevierStylePara elsevierViewall">To calculate the sample size, and because this was the first study to evaluate a new stain for the identification of <span class="elsevierStyleItalic">H. pylori</span>, a pilot test was initially conducted with 50 samples assigned by simple random sampling from the study population (30–50 samples are recommended for a pilot test).<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">13,14</span></a> Three histological slides were prepared for each paraffin block, and a single staining method was applied to each slide (Gissell's stain, HE or Giemsa). Two experts examined the slides independently. Subsequently, results were compared to the GS suggested by the EHPSG (positive case: at least two positive tests; negative case: any other result) (contingency tables in <a class="elsevierStyleCrossRef" href="#sec0085">Supplements 1 and 2</a>); obtaining 0.87 as an inter-observer kappa coefficient, 40% positive classifications by observer 1, and 38% by observer 2, SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>94.4%, SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>90.6%, and 36% prevalence.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Based on these data (concordance and diagnostic test statistics), two corresponding sample sizes were calculated, and the largest one was selected as the final sample to be tested (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>99). The level of significance established was 5%, 0.1 precision for the expected kappa coefficient, and 10% precision for the expected SE and SP. These parameters were based on those suggested in exploratory studies.<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">From the study population, both for the pilot test and the analysis of this research, simple random samplings with 50% more than the established samples were carried out to prevent adequate analysis of the exact quantity after the exclusion of some samples by the selection criteria. Epidat software v.4.2 was used for sample size calculation and simple random sampling.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Inclusion criteria: Gastric paraffin blocks registered in the laboratory software during 2020.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Exclusion criteria: Gastric paraffin blocks that did not have residual tissue for new slides or were damaged, not found in the storage cabinet (referred to other laboratories), unclear identification (blurred or damaged frame) or more than one gastric paraffin block from the same person (to prevent possible repetition of information, only the first one chosen by simple random sampling was evaluated).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Procedures</span><p id="par0060" class="elsevierStylePara elsevierViewall">From the selected paraffin blocks, three micron sections were made (conventional slides, without any type of additive), and these were placed in an oven at 85<span class="elsevierStyleHsp" style=""></span>°C for 20<span class="elsevierStyleHsp" style=""></span>min. They were then deparaffinized by two changes in xylene for 5<span class="elsevierStyleHsp" style=""></span>min each. Subsequently, they were hydrated by two changes in absolute ethanol (5<span class="elsevierStyleHsp" style=""></span>min each) and two changes in 96° ethanol (quick changes, 5<span class="elsevierStyleHsp" style=""></span>s each) and each staining protocol was applied.<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">HE staining protocol: Slides were placed in Harris haematoxylin for 5<span class="elsevierStyleHsp" style=""></span>min and rinsed in tap water for 1<span class="elsevierStyleHsp" style=""></span>min. They were then differentiated using 1% acid alcohol for 2<span class="elsevierStyleHsp" style=""></span>s and rinsed in tap water for 1<span class="elsevierStyleHsp" style=""></span>min. Subsequently, bluing was performed using ammoniacal water for 2<span class="elsevierStyleHsp" style=""></span>min and the slides were rinsed again in tap water for 1<span class="elsevierStyleHsp" style=""></span>min. The slides were then placed in Eosin Yellowish-Floxin for 10<span class="elsevierStyleHsp" style=""></span>s and rinsed in tap water for 15<span class="elsevierStyleHsp" style=""></span>s. Finally, slides were dehydrated by two changes in 96° alcohol and two changes in absolute alcohol (quick changes, 5<span class="elsevierStyleHsp" style=""></span>s each), and were subsequently dried using a fan and mounted using synthetic Canada balsam.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">Giemsa staining protocol (Wolbach's modification): Slides were placed in a coplin with 40<span class="elsevierStyleHsp" style=""></span>ml of Giemsa working solution for 2<span class="elsevierStyleHsp" style=""></span>h (a mixture of 1.25<span class="elsevierStyleHsp" style=""></span>ml of Giemsa stock solution, 1.50<span class="elsevierStyleHsp" style=""></span>ml of methyl alcohol, and distilled water up to 50<span class="elsevierStyleHsp" style=""></span>ml). The stock solution was prepared as follows: 1<span class="elsevierStyleHsp" style=""></span>g of Giemsa powder, 66<span class="elsevierStyleHsp" style=""></span>ml each of glycerin and methyl alcohol. Finally, slides were rinsed in tap water for 1<span class="elsevierStyleHsp" style=""></span>min, dehydrated by two changes in 96° alcohol and two changes in absolute alcohol (quick changes, 5<span class="elsevierStyleHsp" style=""></span>s each) and subsequently were dried using a fan, and mounted using synthetic Canada balsam.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall">“Gissell's stain” protocol: This new stain was created by the main author of this research, mixing 1% methylene blue with 1<span class="elsevierStyleHsp" style=""></span>g of sodium bicarbonate and boiling this solution during 10<span class="elsevierStyleHsp" style=""></span>min at 95<span class="elsevierStyleHsp" style=""></span>°C. Heat and a basic pH medium favour the formation of azures,<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> which have a greater affinity (intensity) for basophilic substances, such as the nucleic acids of <span class="elsevierStyleItalic">H. pylori</span>, which are dispersed throughout the cytoplasm. Once the solution was cooled (and stored at room temperature), two drops were applied to a slide (just enough to cover the tissue) for 2<span class="elsevierStyleHsp" style=""></span>s. Finally, the slides were rinsed in tap water for 10<span class="elsevierStyleHsp" style=""></span>s, and subsequently (no dehydration step) dried using a fan and mounted using synthetic Canada balsam. It was designed to be cheaper and faster than traditional methods.</p></li></ul></p><p id="par0080" class="elsevierStylePara elsevierViewall">The slide coding algorithm (written on the top of the slides) was created as follows: it consists of a number that represents the type of method used (HE was considered as 1, Giemsa as 2, and “Gissell's stain” as 3) multiplied by 2, followed by the order of the gastric paraffin block from the list of those selected and, finally, by the addition of 1, 2, and 3 to these previous numbers, respectively. For example, following the previously explained coding, case 1 presented codes 2122, 4143, and 6164 for HE, Giemsa, and “Gissell's stain” methods, respectively. This complex coding was applied to prevent observers from identifying which case corresponded to a certain staining method and thus reduce the influence of corroborating results by different methods.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Subsequently, these slides were randomly delivered to two experts (pathologists with five and six years of experience) who observed them independently (different places and times) and reported the results on physical data collection sheets.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Finally, the information provided was typed in an Excel form and subsequently imported into statistical software.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0095" class="elsevierStylePara elsevierViewall">Descriptive analyses were performed by calculating the relative and absolute frequencies. The conventional kappa statistic was calculated by the appropriate software, and it was categorized in: no level of agreement (0–0.20); minimum agreement (0.21–0.39); weak agreement (0.40–0.59); moderate agreement (0.60–0.79); strong agreement (0.80–0.90) and almost perfect agreement (>0.90).<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> The adjusted kappa coefficient (PABAK) was also reported because the “conventional” one is always influenced by the inter-observer bias and prevalence of the disease. It was calculated as follows: PABAK<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleItalic">p</span>0<span class="elsevierStyleHsp" style=""></span>−<span class="elsevierStyleHsp" style=""></span>1. Legend: <span class="elsevierStyleItalic">p</span>0<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">a</span><span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">d</span>/<span class="elsevierStyleItalic">N</span>, negative by both observers (<span class="elsevierStyleItalic">a</span>), positive by both observers (<span class="elsevierStyleItalic">d</span>), sample size (<span class="elsevierStyleItalic">N</span>).</p><p id="par0100" class="elsevierStylePara elsevierViewall">For diagnostic capacity statistics (sensitivity, specificity, and predictive values), only the results of the observer with the most years of experience were considered, and the GS suggested by the EHPSG (positive case: at least two positive tests; negative case: any other result) was applied considering only HE and Giemsa, because these are validated methods. As “Gissell's stain” is a new proposal, it was evaluated individually to test how it compared with the GS. The statistics were calculated as follows:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0105" class="elsevierStylePara elsevierViewall">SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>TP/(FN<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>TP); TP: true positives, FN: false negatives.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0110" class="elsevierStylePara elsevierViewall">SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>TN/(FP<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>TN); TN: true negatives, FP: false positives.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0115" class="elsevierStylePara elsevierViewall">PPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>TP/(FP<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>TP).</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0120" class="elsevierStylePara elsevierViewall">NPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>TN/(FN<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>TN).</p></li></ul></p><p id="par0125" class="elsevierStylePara elsevierViewall">Data analyses were performed using STATA v.17.0 (license: 301709060352), and <span class="elsevierStyleItalic">p</span> values less than 0.05 were considered significant.</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Selection of participating samples</span><p id="par0130" class="elsevierStylePara elsevierViewall">After sampling for the pilot test (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>50) from the study population (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>725), a total of six paraffin blocks were excluded: three samples that were not found in the file cabinet and three samples that had very worn surfaces. No paraffin blocks were excluded because of the last two established criteria (doubtful or inadequate identification, and more than one paraffin block coming from the same person and from the same gastric region).</p><p id="par0135" class="elsevierStylePara elsevierViewall">After sampling for proper analysis (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>99) from the study population (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>725), a total of 13 paraffin blocks were excluded: eight samples that were not found in the file cabinet, and five samples that had very worn surfaces.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Description of the results</span><p id="par0140" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows that the prevalences of <span class="elsevierStyleItalic">H. pylori</span> established by HE, Giemsa, “Gissell's stain” and the GS were 25.2%, 33.3%, 39.4%, and 35.4%, respectively.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">The prevalence rates of foveolar hyperplasia, lymphoid follicles, intestinal metaplasia, atrophy and gastric dysplasia were 4%, 15.1%, 11.1%, 6.1% and 3%, respectively.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Additionally, characteristics such as partial focal mucinous damage (40.4%), gastric antrum area (57.6%), superficial infiltration (52.5%), and moderate activity (39.4%) were observed in patients with chronic gastritis.</p><p id="par0155" class="elsevierStylePara elsevierViewall">The improvements in the quantity and quality of observations of bacilli in the same field, according to each staining method, are shown in <a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Concordance and diagnostic capacity</span><p id="par0160" class="elsevierStylePara elsevierViewall">Based on the information from the contingency tables (<a class="elsevierStyleCrossRef" href="#sec0085">Supplements 3 and 4</a>), the statistics are presented in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.<ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0165" class="elsevierStylePara elsevierViewall">“Gissell's stain” showed the highest inter-observer agreement (kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.87, strong agreement) compared with the other two methods (HE, kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.51, weak agreement; Giemsa, kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.83, strong agreement). In addition, it was the least affected by disease prevalence and observer bias (adjusted kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.88) compared with the other two methods (HE, adjusted kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.66; Giemsa, adjusted kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.86).</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">-</span><p id="par0170" class="elsevierStylePara elsevierViewall">“Gissell's stain” showed the highest sensitivity (97.1%) compared with the other two methods (HE: 68.6%, Giemsa: 88.6%). However, the same method obtained the lowest specificity (92.2%) compared with the other two methods (HE: 98.4%, Giemsa: 96.9%). HE showed the highest positive predictive value (96%) compared with the other two methods (Giemsa: 93.9%, “Gissell's stain”: 87.2%). In contrast, it obtained the lowest negative predictive value (85.1%) compared with the other two methods (Giemsa: 93.9%, “Gissell's stain”: 98.3%).</p></li></ul></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discussion</span><p id="par0175" class="elsevierStylePara elsevierViewall">The inter-observer agreement for HE in this study (kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.51) coincided with various investigations that reported values in the range of weak agreement (0.40–0.59).<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">18–21</span></a> However, it differed from the studies by Chen et al.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a> and Vásquez et al.,<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a> which reported kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.76 and kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.62 (both represent moderate agreements), respectively. The difference with the first study could be due to the population sample, which included patients who already had <span class="elsevierStyleItalic">H. pylori</span> infection, to compare pre- and post-treatment inter-observer agreement for its identification. Thus, this would influence the prevalence of the disease and, therefore, the kappa statistic. The difference with the second study could be because 20% of slides were recoloured. Given that a group was partially treated, this probably generates a measurement bias, which would affect the report of this bacterium and, therefore, the kappa statistic.</p><p id="par0180" class="elsevierStylePara elsevierViewall">The inter-observer agreement for Giemsa in this study (kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.83, strong concordance) disagrees with the total number of studies that evaluated inter-observer concordance for this method, Toro et al.<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">19</span></a> and Rotimi et al.,<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a> who reported kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.64 and kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.73 (both representing moderate agreements), respectively. The difference with the first study could be because the sample size calculation was performed only for diagnostic capacity (using the sensitivity found in a pilot test), but not for concordance. In addition, a pilot test was conducted with only 15 samples, which is less than the recommended number. Thus, all these results could indicate that the estimated kappa would not have adequate statistical precision. The difference with the second study could be because, in cases where there was disagreement between the observers, the slides were observed under a double-headed microscope to reach a consensus in the report. Hence, there was no independent observation, and, as in the previous case, the results would probably be biased by the partial treatment given to a group of slides (measurement bias).</p><p id="par0185" class="elsevierStylePara elsevierViewall">Furthermore, none of the previous investigations reported the adjusted kappa; therefore it is not possible to determine which staining method would be more affected by inter-observer bias and the prevalence of the disease. On the other hand, the inter-observer kappa statistic of “Gissell's stain”, was the best compared with Giemsa and HE. In addition, it presented a variation of only 0.1 with respect to its adjusted value. This means that this new stain could be applied practically in any population (regardless of prevalence) or the slides could be examined by any pathologist (regardless of experience).</p><p id="par0190" class="elsevierStylePara elsevierViewall">The diagnostic capacity values for HE in this study (SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>68.6%, SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>98.4%, PPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>96%, NPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>85.1%) were similar to those reported by Allahverdiyev et al. (SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>65%, SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>100%, PPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>100%, NPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>74%),<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a> but differed (only for SE and NPV) from those reported by Ali et al. (SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>81.2%, SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>100%, PPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>100%, NPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>63.4).<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">5</span></a> Both studies used the GS recommended by the EHPSG.</p><p id="par0195" class="elsevierStylePara elsevierViewall">The difference with Ali et al. could be due to two reasons. First, a sample size calculation was not performed considering the diagnostic capacity statistics. Therefore, statistical power may not be adequate. In addition, the prevalence in that investigation (75.5%) was more than double that found in the present study (35.4%). Prevalence is a characteristic that affects diagnostic capacity, specifically the predictive values.</p><p id="par0200" class="elsevierStylePara elsevierViewall">In comparison with investigations that did not apply the recommended GS, a greater difference could be observed, especially for the predictive values (SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>69.7–100%, SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>74.3–100%, PPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>50–100%, NPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>36.4–100%).<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">4,6,8–10,26–28</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">The diagnostic capacity values for Giemsa in this study (SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>88.6%, SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>96.9%, PPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>93.9%, NPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>93.9%) also differs (specially for the predictive values because the range is wider) from the total of investigations that evaluated these statistics (SE<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>62–100%, SP<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>84.5–100%, PPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>59.1–100%, NPV<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>75–100%).<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">4,6–9,26</span></a> Although the difference is smaller compared to the HE method, this could be explained by the fact that Giemsa allows a better visualization of the bacterium. In the same way, this discrepancy could be because all these studies only considered a single invasive method as GS. To avoid this heterogeneity in the results, it is important to apply the GS suggested by the EHPSG.</p><p id="par0210" class="elsevierStylePara elsevierViewall">In contrast, “Gissell's stain” method presented the best sensitivity and negative predictive value. This could be due to the fact that it intensifies the colour produced by the alkaline medium (heat and sodium bicarbonate in its preparation), which allows the formation of azures<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> and these have a greater affinity for basophilic substances, such as the nucleic acids of <span class="elsevierStyleItalic">H. pylori</span>, which are dispersed throughout the cytoplasm, thus improving recognition. However, this intensity could also influence the observer and produce some false positives, which would explain the lower specificity (although still considerable, since it was more than 90%) compared with the other staining methods. This reaffirms that there is no single perfect method and that the consideration of a reference using at least two staining methods is crucial.</p><p id="par0215" class="elsevierStylePara elsevierViewall">Although this study could not compare the new stain with the optimal ones such as immunohistochemistry and silver impregnations, it presented strengths such as comparison with the current Gold Standard suggested by the EHPSG, and a sample size that was calculated considering a confidence level of 95%, unlike many previous investigations that analyzed samples without justifying it.</p><p id="par0220" class="elsevierStylePara elsevierViewall">Finally, we consider that the new stain should be further studied by comparing it with immunohistochemistry and silver impregnations, and that the following identification algorithm be evaluated in order to establish the best routine method: HE (best specificity) and “Gissell's stain” (best sensitivity), as they could prove complementary.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusion</span><p id="par0225" class="elsevierStylePara elsevierViewall">In conclusion, given its unique characteristics (fast, cheap, accessible and easy to use), in addition to its statistical reliability, “Gissell's stain” has great potential for application in the routine identification of <span class="elsevierStyleItalic">H. pylori</span>.</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Authors’ contributions</span><p id="par0230" class="elsevierStylePara elsevierViewall">GCRU conceived of the presented idea, performed the experiments and analysis, and drafted the manuscript; MBT and RCB contributed recommendations for the design and read the histological slides; RNM and ESG contributed recommendations for the design and performed the experiments. All authors discussed the results and approved the final manuscript.</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Ethical aspects</span><p id="par0235" class="elsevierStylePara elsevierViewall">This research was approved by the Chief of the Taxa Oncological Laboratory.</p><p id="par0240" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the ethical considerations in accordance with the Declaration of Helsinki and the regulations of their institution.</p><p id="par0245" class="elsevierStylePara elsevierViewall">There are no identifiable human data in the article. The samples stored in the Pathology department were collected for diagnostic purposes to promote and ensure the health of the patients and in no case was an additional procedure considered that involved the concept of experimentation on patients.</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Funding</span><p id="par0250" class="elsevierStylePara elsevierViewall">This research was self-funded.</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflict of interest</span><p id="par0255" class="elsevierStylePara elsevierViewall">The authors declare that they have NO affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:15 [ 0 => array:3 [ "identificador" => "xres1995897" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1712441" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1995896" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1712440" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study design and setting" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Study population and sample" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Procedures" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0035" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Selection of participating samples" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Description of the results" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Concordance and diagnostic capacity" ] ] ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0060" "titulo" => "Conclusion" ] 9 => array:2 [ "identificador" => "sec0065" "titulo" => "Authors’ contributions" ] 10 => array:2 [ "identificador" => "sec0070" "titulo" => "Ethical aspects" ] 11 => array:2 [ "identificador" => "sec0075" "titulo" => "Funding" ] 12 => array:2 [ "identificador" => "sec0080" "titulo" => "Conflict of interest" ] 13 => array:2 [ "identificador" => "xack698224" "titulo" => "Acknowledgments" ] 14 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-03-15" "fechaAceptado" => "2023-05-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1712441" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Helicobacter pylori</span>" 1 => "Azure stains" 2 => "Histological techniques" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1712440" "palabras" => array:3 [ 0 => "<span class="elsevierStyleItalic">Helicobacter pylori</span>" 1 => "Tinciones azules" 2 => "Técnicas histológicas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The histopathological identification of <span class="elsevierStyleItalic">Helicobacter pylori</span> using the routine method (haematoxylin–eosin) is not only very difficult but also has low sensitivity. Giemsa staining is often used in addition, but different protocols do not produce homogeneous results. Furthermore, the Gold Standard recommended by the European Helicobacter Pylori Study Group has been applied in very few studies, thus resulting in uncertain outcomes. Therefore, a new staining method is required to overcome these limitations. The aim of this study was to evaluate the diagnostic capacity and inter-observer agreement of “Gissell's stain”.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A cross-sectional study evaluated 99 gastric paraffin blocks from a private laboratory. Three sections were prepared from each block, and haematoxylin–eosin (HE), Giemsa and “Gissell's stain” methods were applied. The kappa statistics, sensitivity, specificity, and predictive values were calculated.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">“Gissell's stain” obtained the highest inter-observer agreement (kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.87) compared to the other two methods (HE, kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.51; Giemsa, kappa<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.83). It also obtained the best sensitivity and negative predictive value (97.1% and 98.3%, respectively) compared with the other two methods (HE: 68.6% and 85.1%, respectively; Giemsa: 88.6% and 93.9%, respectively).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Given its unique characteristics (fast, cheap, accessible, and easy to use), in addition to its statistical reliability, “Gissell's stain” has great potential for routine use in the identification of <span class="elsevierStyleItalic">H. pylori</span>.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La identificación histopatológica del <span class="elsevierStyleItalic">Helicobacter pylori</span>, utilizando hematoxilina-eosina (HE) como método de rutina es frecuentemente dificultosa y con una baja sensibilidad. El método de Giemsa es usado a veces de modo adicional, pero diferentes protocolos no producen resultados homogéneos. Además, el método recomendado por el grupo europeo de estudio de <span class="elsevierStyleItalic">Helicobacter pylori</span> ha sido empleado en pocos estudios, resultando en datos discrepantes. Por tanto, un método alternativo eficaz podría superar estas limitaciones. El presente estudio valora la agudeza diagnostica y el acuerdo interobservador en la aplicación del método de Gissell.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Un estudio interobservador de 99 biopsias gástricas provenientes de la practica privada. De cada caso se prepararon tres muestras teñidas correspondientemente con: HE, Giemsa y Gissell. Se procedió mediante estadística kappa a valorar la sensibilidad, especificidad y valores predictivos.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La técnica de Gissell obtuvo el mayor acuerdo interobservador con un kappa con 0,87, comparado con la HE (kappa = 0,51) y Giemsa (kappa = 0,83). Además, obtuvo la mayor sensibilidad y valor predictivo negativo comparado con los otros dos métodos.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Dadas sus características prácticas, tales como rapidez, economía, accesibilidad y facilidad de uso, además de su fiabilidad estadística, el método de Gissell posee un gran potencial para la identificación rutinaria del <span class="elsevierStyleItalic">Helicobacter pylori</span>.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0270" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix B" "titulo" => "Supplementary material" "identificador" => "sec0090" ] ] ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1023 "Ancho" => 1813 "Tamanyo" => 290708 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Presence of <span class="elsevierStyleItalic">Helicobacter pylori</span> by each staining method (40×). (A) Haematoxylin–eosin. (B) Giemsa. (C) “Gissell's stain”.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1022 "Ancho" => 1813 "Tamanyo" => 367317 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Presence of <span class="elsevierStyleItalic">Helicobacter pylori</span> by each staining method (40×). (A) Haematoxylin–eosin. (B) Giemsa. (C) “Gissell's stain”. Case that could potentially be scored negative for A or B, but not for the new staining method (C).</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">HP: <span class="elsevierStyleItalic">Helicobacter pylori</span>; HE: haematoxylin–eosin.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristics \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">N</span> (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">HP – HE</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 (74.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25 (25.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">HP – GIEMSA</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 (66.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">HP – “Gissell's stain”</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 (60.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (39.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">HP – Gold Standard</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 (64.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 (35.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Foveolar hyperplasia</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">95 (96.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (4.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Infiltration of chronic gastritis</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Superficial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">52 (52.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Deep \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47 (47.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Chronic gastritis activity</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>None \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (30.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 (30.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 (39.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Lymphoid follicles</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 (84.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (15.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Mucinous damage</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>None \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (17.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Focal partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40 (40.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multifocal partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 (36.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Focal total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (2.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Multifocal total \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 (4.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Intestinal metaplasia</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 (88.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (11.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Gastric atrophy</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93 (93.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 (6.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Gastric dysplasia</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96 (97.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (3.0) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Provenance of gastric biopsy</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Antrum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 (42.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Body \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 (57.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3316872.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Description of the sample (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>99).</p>" ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">HE: haematoxylin–eosin; <span class="elsevierStyleItalic">S</span>: standard error; <span class="elsevierStyleItalic">p</span>: <span class="elsevierStyleItalic">p</span> value; SE: sensitivity; SP: specificity; PPV: positive predictive value; NPV: negative predictive value.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Statistic \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HE \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">GIEMSA \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">“Gissell's stain” \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Kappa/<span class="elsevierStyleItalic">S</span>/<span class="elsevierStyleItalic">p</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.51/0.0995/<0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.83/0.0991/<0.001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.87/0.1001/<0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Adjusted kappa \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.66/0.55/0.05 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.86/0.40/0.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.88/0.25/0.04 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">97.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">92.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PPV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">96% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NPV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3316871.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Inter-observer agreement and diagnostic capacity of each staining method.</p>" ] ] 4 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 111367 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0145" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histopathological analysis of chronic gastritis and correlation of pathological features with each other and with endoscopic findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Garg" 1 => "V. Sandhu" 2 => "N. Sood" 3 => "A. Sood" 4 => "V. Malhotra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5114/pjp.2012.31501" "Revista" => array:6 [ "tituloSerie" => "Pol J Pathol" "fecha" => "2012" "volumen" => "63" "paginaInicial" => "172" "paginaFinal" => "178" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23161233" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0150" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "New algorithm to differentiate histochemical types of intestinal metaplasia: G&S2 method" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.C. Ramirez-Ubillus" 1 => "C.R. Neira-Montoya" 2 => "E.E. Sedano-Gelvet" 3 => "J.F. Verona-Cueva" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bras Patol Med Lab" "fecha" => "2022" "volumen" => "58" "paginaInicial" => "1" "paginaFinal" => "6" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0155" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Appropriate use of special stains for identifying <span class="elsevierStyleItalic">Helicobacter pylori</span>: recommendations from the Rodger C. Haggitt Gastrointestinal Pathology Society" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K.P. Batts" 1 => "S. Ketover" 2 => "S. Kakar" 3 => "A.M. Krasinskas" 4 => "K.A. Mitchell" 5 => "R. Wilcox" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PAS.0000000000000097" "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "e12" "paginaFinal" => "e22" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24141174" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0160" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Helicobacter pylori</span> detection in chronic gastritis: a comparison of staining methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Ahmad" 1 => "R. Jaffar" 2 => "I. Khan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Ayub Med Coll Abbottabad" "fecha" => "2011" "volumen" => "23" "paginaInicial" => "112" "paginaFinal" => "114" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0165" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of endoscopy based <span class="elsevierStyleItalic">H. pylori</span> diagnostic techniques in iraqi patients with upper gastrointestinal disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.E. Ali" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "INDJST" "fecha" => "2016" "volumen" => "9" "paginaInicial" => "1" "paginaFinal" => "10" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0170" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Are routine ancillary stains required to diagnose helicobacter infection in gastric biopsy specimens? An institutional quality assurance review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.J. Hartman" 1 => "S.R. Owens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1309/AJCPD8FFBJ5LSLTE" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Pathol" "fecha" => "2012" "volumen" => "137" "paginaInicial" => "255" "paginaFinal" => "260" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22261451" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0175" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sensitivity of <span class="elsevierStyleItalic">Helicobacter pylori</span> detection by Giemsa staining is poor in comparison with immunohistochemistry and fluorescent in situ hybridization and strongly depends on inflammatory activity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "É. Kocsmár" 1 => "I. Szirtes" 2 => "Z. Kramer" 3 => "A. Szijártó" 4 => "L. Bene" 5 => "G.M. Buzás" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Helicobacter" "fecha" => "2017" "volumen" => "22" "paginaInicial" => "1" "paginaFinal" => "9" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0180" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histological identification of <span class="elsevierStyleItalic">Helicobacter pylori</span>: comparison of staining methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Pranjal" 1 => "M. Kalpana" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Med Res Rev" "fecha" => "2015" "volumen" => "3" "paginaInicial" => "1167" "paginaFinal" => "1173" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0185" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Detection of <span class="elsevierStyleItalic">Helicobacter pylori</span> in gastric biopsies of patients with chronic gastritis: histopathological and immunohistochemical study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Bamanikar" 1 => "A. Khandelwal" 2 => "K. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Health Sci Res" "fecha" => "2018" "volumen" => "8" "paginaInicial" => "39" "paginaFinal" => "47" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0190" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Warthin–Starry staining for the detection of <span class="elsevierStyleItalic">Helicobacter pylori</span> in gastric biopsies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W.I. Farouk" 1 => "N.H. Hassan" 2 => "T.R. Ismail" 3 => "I.S. Daud" 4 => "F. Mohammed" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Malays J Med Sci" "fecha" => "2018" "volumen" => "25" "paginaInicial" => "92" "paginaFinal" => "99" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0195" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identificación histológica de <span class="elsevierStyleItalic">Helicobacter pylori</span> por los métodos de tinción de Warthins–Stary y Giménez en biopsias gástricas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Marín" 1 => "P. Salas" 2 => "F. Mena" 3 => "R. Sierra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Méd Costa Rica Centroam" "fecha" => "1996" "volumen" => "63" "paginaInicial" => "147" "paginaFinal" => "151" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0200" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current concepts in the management of <span class="elsevierStyleItalic">Helicobacter pylori</span> infection – the Maastricht 2-2000 Consensus Report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Malfertheiner" 1 => "F. Mégraud" 2 => "C. O’Morain" 3 => "A.P.S. Hungin" 4 => "R. Jones" 5 => "A. Axon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2036.16.s2.20.x" "Revista" => array:6 [ "tituloSerie" => "Aliment Pharmacol Ther" "fecha" => "2002" "volumen" => "16" "paginaInicial" => "167" "paginaFinal" => "180" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11966537" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0205" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metodología del estudio piloto" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Díaz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Revista Chilena de Radiología" "fecha" => "2020" "volumen" => "26" "paginaInicial" => "100" "paginaFinal" => "104" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0210" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Características de la prueba piloto: revisión de artículos publicados en enfermería" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.A. Mora" 1 => "A.A.S. Carrasco" 2 => "V.P.M. Muñoz" 3 => "R.S. Salinas" 4 => "S.C. Huerta" 5 => "E.P. Noriega" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Revista de Enfermería Neurológica" "fecha" => "2015" "volumen" => "14" "paginaInicial" => "169" "paginaFinal" => "175" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0215" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tamaño muestral en estudios biomédicos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T.G. Duffau" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Revista Chilena de Pediatría" "fecha" => "1999" "volumen" => "70" "paginaInicial" => "314" "paginaFinal" => "324" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0220" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neutral stains" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.D. Lillie" 1 => "H.J. Conn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "paginaInicial" => "430" "edicion" => "8th ed." "serieTitulo" => "Biological stains: a handbook on the nature and uses of the dyes employed in the biological laboratory" "serieFecha" => "1969" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0225" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interrater reliability: the kappa statistic" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.L. McHugh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jocd.2012.03.005" "Revista" => array:6 [ "tituloSerie" => "Biochem Med (Zagreb)" "fecha" => "2012" "volumen" => "22" "paginaInicial" => "276" "paginaFinal" => "282" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23092060" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0230" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A reliable method for the simultaneous identification of <span class="elsevierStyleItalic">H. pylori</span> and gastric metaplasia in the duodenum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.M. el-Zimaity" 1 => "J. Wu" 2 => "T. Akamatsu" 3 => "D.Y. Graham" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jcp.52.12.914" "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "1999" "volumen" => "52" "paginaInicial" => "914" "paginaFinal" => "916" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10711255" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0235" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparación de las tinciones Hematoxilina-Eosina y Giemsa para la identificación de <span class="elsevierStyleItalic">Helicobacter pylori</span> en muestras de biopsia gástrica de pacientes del hospital IESS Riobamba entre octubre y diciembre del 2009" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.J. Toro Arias" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2010" "editorial" => "Pontificia Universidad Católica del Ecuador" "editorialLocalizacion" => "Perú" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0240" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interobserver variability in application of the revised Sydney classification for gastritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Guarner" 1 => "R. Herrera" 2 => "A. Mohar" 3 => "L. Sanchez" 4 => "D. Halperin" 5 => "C. Ley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0046-8177(99)90164-8" "Revista" => array:6 [ "tituloSerie" => "Hum Pathol" "fecha" => "1999" "volumen" => "30" "paginaInicial" => "1431" "paginaFinal" => "1434" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10667420" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0245" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interobserver agreement in the assessment of gastritis reversibility after <span class="elsevierStyleItalic">Helicobacter pylori</span> eradication" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Tepes" 1 => "V. Ferlan" 2 => "A. Jutersek" 3 => "B. Kavcic" 4 => "L. Zaletel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2559.1999.00604.x" "Revista" => array:6 [ "tituloSerie" => "Histopathology" "fecha" => "1999" "volumen" => "34" "paginaInicial" => "124" "paginaFinal" => "133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10064391" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0250" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interobserver variation in the histopathological scoring of <span class="elsevierStyleItalic">Helicobacter pylori</span> related gastritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X.Y. Chen" 1 => "R.W. Van der Hulst" 2 => "M.J. Bruno" 3 => "A. Van der Ende" 4 => "S.D. Xiao" 5 => "G.N. Tytgat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/jcp.52.8.612" "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "1999" "volumen" => "52" "paginaInicial" => "612" "paginaFinal" => "615" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10645232" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0255" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Variabilidad interobservador en la identificación de <span class="elsevierStyleItalic">Helicobacter pylori</span> en biopsias gástricas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.T. Vásquez Montoya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2008" "editorial" => "Universidad Nacional de Trujillo" "editorialLocalizacion" => "Perú" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0260" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histological identification of <span class="elsevierStyleItalic">Helicobacter pylori</span>: comparison of staining methods" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "O. Rotimi" 1 => "A. Cairns" 2 => "S. Gray" 3 => "P. Moayyedi" 4 => "M.F. Dixon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Clin Pathol" "fecha" => "2000" "volumen" => "53" "paginaInicial" => "756" "paginaFinal" => "759" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0265" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolation and diagnosis of <span class="elsevierStyleItalic">Helicobacter pylori</span> by a new method: microcapillary culture" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Allahverdiyev" 1 => "M. Bagirova" 2 => "R. Caliskan" 3 => "H.B. Tokman" 4 => "H. Aliyeva" 5 => "G. Unal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v21.i9.2622" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2015" "volumen" => "21" "paginaInicial" => "2622" "paginaFinal" => "2628" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25759529" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0270" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of <span class="elsevierStyleItalic">Helicobacter pylori</span> by different conventional staining techniques and its comparison with polymerase chain reaction" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Himani" 1 => "J.S. Patel" 2 => "H.H. Agravat" 3 => "S.B. Patel" 4 => "M.C. Thakkar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Saudi Med J" "fecha" => "2013" "volumen" => "34" "paginaInicial" => "942" "paginaFinal" => "948" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0275" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reliability of diagnostic tests for <span class="elsevierStyleItalic">Helicobacter pylori</span> infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Redéen" 1 => "F. Petersson" 2 => "E. Törnkrantz" 3 => "H. Levander" 4 => "E. Mårdh" 5 => "K. Borch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Gastroenterol Res Pract" "fecha" => "2011" "volumen" => "2011" "paginaInicial" => "940650" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0280" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluación de la utilidad de diferentes métodos para el diagnóstico de <span class="elsevierStyleItalic">Helicobacter pylori</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Soto" 1 => "B.L. Rodríguez González" 2 => "A. Moreno Guerra" 3 => "L. Chao González" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Revista Cubana de Investigaciones Biomédicas" "fecha" => "2013" "volumen" => "32" "paginaInicial" => "102" "paginaFinal" => "110" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack698224" "titulo" => "Acknowledgments" "texto" => "<p id="par0260" class="elsevierStylePara elsevierViewall">To Gissell Tavera Veramatus for her unconditional support and for being the best woman and mother. To Israel Ramirez, Biosix company owner, for allowing the scanning of slides for free (publication images).</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/16998855/0000005600000004/v1_202310250520/S1699885523000442/v1_202310250520/en/main.assets" "Apartado" => array:4 [ "identificador" => "7944" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/16998855/0000005600000004/v1_202310250520/S1699885523000442/v1_202310250520/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699885523000442?idApp=UINPBA00004N" ]
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Initial assessment of “Gissell's stain”: A novel histopathological method for the identification of Helicobacter pylori
Valoración inicial de la tinción de Gissell, un nuevo método histopatológico en la identificación del Helicobacter pylori