皮肤淀粉样变中淀粉样蛋白4种染色法的比较

A Comparative Study on Four Special Stains for the Amyloid of Cutaneous Amyloidosis

目的对4种特殊染色法显示淀粉样蛋白的优劣进行对比分析,为原发性皮肤淀粉样变探寻更好的组织病理学诊断方法。方法将本院皮肤科近10年确诊为原发性皮肤淀粉样变的33例皮损组织石蜡标本重新切片后分别进行刚果红、甲基紫、结晶紫和过碘酸雪夫氏反应(PAS)4种特殊染色,显微镜下观察组织切片中淀粉样蛋白的染色情况。结果33例标本中的淀粉样蛋白经4种特殊染色后均呈阳性着色;刚果红、甲基紫、结晶紫和PAS分别将淀粉样蛋白染成砖红色、蓝紫色、紫色和紫红色;前3种方法的染色效果不稳定,部分切片中可见淀粉样蛋白与周围组织分辨不清;而在所有PAS染色切片中,淀粉样蛋白与周围组织的颜色对比明显,但其特异性不强。结论在选择确诊原发性皮肤淀粉样变的特染方法时,PAS染色结合其他3种染色中的任何一种能够弥补单一方法的不足。

Objective To compare four special stains for the amyloid of primary cutaneous amyloidosis（PCA） and to find better histopathological methods for the diagnosis of PCA. Methods Foimalin-fixed and paraffin-embedded sections of the biopsies from 33 PCA patients were stained by Congo red, Methyl violet, Crystal violet and PAS, respectively. Then,microscope observation was performed on amyloids. Results The amyloid stained by four special stains in 33 specimens were all positive, showing brick red, blue, violet and purplish red individully ;and PAS had more stable staining effect than the others,but less specific. Conclusions PAS combination with any one of the other three stains would be the best choice for the pathological diagnosis of PCA.