Dr. Kocsmár and Dr. Lotz have made important comments [1] and raised good questions about recommendations for the broader use of immunohistochemistry (IHC) as well as polymerase chain reaction (PCR) testing in cases where an etiological role of H. pylori is clinically suggested, but histopathological confirmation of H. pylori is not possible.
Indeed, the use of IHC could be more valuable in Giemsa-negative cases without inflammatory activity in which the etiological role of H. pylori is suggested by clinical, anamnestic or other data.
Although this leads to the idea of the routine use of IHC as the primary staining method, instead of Giemsa, its rather higher costs of analysis should be taken into account.
On the other hand, PCR testing could also be an option in cases where an etiological role of H. pylori is suspected. We (could) also support the idea of the use of PCR in doubtful cases. Moreover, it turns out that the broader use of molecular methods is also recommended by the last edition of the Maastricht guidelines [2].
In summary, the topic of routine use of IHC and PCR for H. pylori identification should be included in expert discussions as well as in the preparation process of the next guidelines for the management of H. pylori infections.
Author Contributions
Conceptualization, I.D., F.M. and M.L.; writing—original draft preparation, I.D.; writing—review and editing, all authors. All authors have read and agreed to the published version of the manuscript.
Conflicts of Interest
The authors declare no conflict of interest.
References
- Kocsmár, É.; Lotz, G. Comment on Skrebinska et al. Who Could Be Blamed in the Case of Discrepant Histology and Serology Results for Helicobacter pylori Detection? Diagnostics 2022, 12, 133. Diagnostics 2022, 12, 1424. [Google Scholar] [CrossRef]
- Malfertheiner, P.; Megraud, F.; Rokkas, T.; Gisbert, J.P.; Liou, J.M.; Schulz, C.; Gasbarrini, A.; Hunt, R.H.; Leja, M.; O’Morain, C.; et al. Management of Helicobacter pylori infection: The Maastricht VI/Florence consensus report. Gut 2022, 71, 1724–1762. [Google Scholar] [CrossRef] [PubMed]
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