Assessing the diagnostic accuracy of routine hematoxylin and eosin, Alcian Blue/Periodic Acid-Schiff, and Giemsa stains in the detection of

Background: Hematoxylin and Eosin (H&E), Alcian Blue/Periodic Acid-Schiff (AB/PAS), and Giemsa stains are routinely used in the histopathological evaluation of gastric biopsies. However, comparative data on their diagnostic performance and cost-effectiveness in detecting Methods: A retrospective study was conducted on 816 gastric biopsy cases collected between 2019 and 2021. Three slides (H&E, Giemsa, and AB/PAS) were previously prepared from each paraffin-embedded tissue sample and blindly evaluated by three independent examiners. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall diagnostic accuracy were calculated using 2×2 contingency tables. Results: >H&E yielded a sensitivity of 51.6%, specificity of 74.4%, and diagnostic accuracy of 66.4% when compared to Giemsa as the reference standard. In comparison, AB/PAS exhibited a sensitivity of 45.9%, specificity of 73.2%, and an accuracy of 63.7%. When evaluating operational factors, H&E emerged as the most cost-effective and fastest method, while AB/PAS was associated with higher costs and longer processing times. Overall, Giemsa consistently demonstrated superior diagnostic performance across the assessed metrics, positioning it as the more reliable choice for Conclusions: H&E shows potential for initial screening but its limited sensitivity prevents definitive diagnosis. AB/PAS proved less effective and economical. Giemsa maintained superior diagnostic performance. This study provides a comparative methodological assessment, suggesting H&E and Giemsa combinations could enhance detection efficiency and accuracy. Further prospective validation is needed before clinical implementation.