牙龈和舌组织活检在淀粉样变性病诊断中的应用和比较

Application of Gingival and Tongue Biopsy in Diagnosis of Amyloidosis

目的比较牙龈和舌组织活检对淀粉样变性的诊断价值。方法回顾性分析2012年5月至2013年7月在北京协和医院口腔科同时行牙龈及舌组织活检的32例淀粉样变性患者临床资料。其中24例同期由外科行腹壁脂肪组织活检。活检标本由病理科常规制片,行HE染色和刚果红特染。结果组织活检病理示淀粉样变性在光镜下HE染色呈粉红色,刚果红染色呈砖红色;在偏振光显微镜下呈苹果绿双折射性。牙龈组织活检阳性22例,舌组织活检阳性23例,腹壁脂肪组织活检阳性19例。共29例经牙龈和舌组织活检确诊淀粉样变性,口腔组织活检阳性率为90.63%。经卡方检验,牙龈和舌组织活检对于淀粉样变性的检出结果差异无统计学意义(P>0.05)。结论牙龈和舌组织活检均可提供淀粉样变性病诊断重要依据。

Objective To evaluate and compare the diagnostic values of gingival and tongue biopsies in amyloidosis .Methods We retrospectively analyzed the clinical data of 32 amyloidosis patients who underwent gingival and tongue biopsies in Department of Stomatology of Peking Union Medical College Hospital from May 2012 to July 2013.Among them, 24 patients received abdominal fat biopsy in Department of General Surgery in the same period .Specimens were sliced in routine process , followed by staining with HE and Congo red .Results On light microscopy , amyloidosis was demonstrated as pink stains in HE staining , brick red in Congo red staining, and in polarized light , apple-green birefringent deposits .Gingival biopsy was positive in 22 cases, tongue biopsy in 23 cases, and abdominal fat biopsy in 19 cases.In total, 29 amyloidosis cases were confirmed by gingival and tongue biopsies （ positive rate 90.63%） .Chi-squared test revealed no statistically significant difference between gingival biopsy and tongue biopsy in detecting amyloidosis （ P 〉0.05 ） .Conclusion Gingival and tongue biopsies can both provide solid diagnostic evidence in amyloidosis .