An easy method to highlight chief cells in gastric biopsies.

BACKGROUND Hematoxylin and eosin (H&E) is not an optimal stain to discriminate chief cells from parietal cells in gastric biopsies MATERIALS AND METHODS Fifteen sets of biopsies from the gastric corpus were consecutively stained with H&E and toluidine blue stains; chief cells stained deep blue with toluidine blue, thus contrasting with lightly-stained parietal cells. In well-oriented sections, the continuity of the chief cell zone was studied at × 4 magnification and its thickness in one field at × 10 magnification. RESULTS Toluidine blue stained fundic sections that exhibited normal mucosa or chronic gastritis without glandular atrophy displayed a distinct deep-blue chief cell zone, intercalated between the lightly-stained parietal cells on top and the muscularis mucosae underneath (Group A). In chronic gastritis with focal glandular atrophy or focal intestinal metaplasia, at least one focally fragmented toluidine blue chief cell zone was seen (Group B). In one case with severe autoimmune gastritis and in a case with extensive intestinal metaplasia, an absence of toluidine blue chief cells zone was recorded in the entire section (Group C). CONCLUSION This quick and easy staining method made it possible to group sections from the gastric corpus into those with a continuous chief cell zone, with fragmented or with an absent chief cell zone, modalities that seem to correlate with different stages of fundic mucosal inflammation. These preliminary results should be validated in a larger cohort of gastric biopsies from patients with various diseases affecting the corpus mucosa.