免疫组化方法在检测肾淀粉样变中的应用

Pathological Comparison of Three Methods on Renal Amyloidosis

【目的】探讨应用甲基紫染色、刚果红染色和免疫组化3种方法检测38例不同类型的肾淀粉样变的效果。【方法】将38例肾标本常规处理后,分别用甲基紫、刚果红染色和免疫组化3种方法进行检测,统计检测结果并分析。【结果】甲基紫染色能够准确检测肾淀粉样变,但不能进行分型,且需及时观察;刚果红染色能够准确检测肾淀粉样变,联合氧化后的刚果红染色能够区分AA型与AL型淀粉样变;免疫组化检测能够准确检测肾淀粉样变,并对其进行分型,AA型SAA蛋白阳性,AL型kappa和lambda蛋白阳性。【结论】3种方法均能准确检测肾淀粉样变,而刚果红染色和免疫组化能够进一步分型,建议临床上将刚果红染色和免疫组化联合应用,以利于淀粉样变的诊断及确定分型,同时避免试剂和人为操作等造成的误诊和漏诊。

[Objective] To explore effect of methyl violet dyeing, Congo red staining and immunohistoehemical method on the 38 cases of renal amyloidosis. [ Methods ] 38 cases of tissue samples after conventional treatment were respectively stained with methyl violet and Congo red staining and immunohistochemical method, and were analyzed by statistical method. [ Results ] methyl violet dyeing can accurately detect renal amyloidosis, but cannot be parting the type, and need timely observation; Congo red staining can accurately detect renal amyloidosis, and can separate AA type and type AL amyloidosis; Immunohistochemical detection can accurately detect renal amyloidosis, and carries on the classification. [Conclusion] All these methods can accurately detect renal amyloidosis, Congo red staining and immunohistochemical can further classification. Combination of Congo red staining and SAA immunohistochemistry can accurately detect renal amyloidosis, avoid misdiagnosis caused by reagent or human operation.