改良Masson染色法在慢性乙型肝炎及肝硬化病理学诊断中应用

Application of Modified Masson Staining Method in Diagnosis of Chronic Hepatitis B and Liver Cirrhosis Pathology

目的研究一种改良的Masson染色方法用来显示肝组织中胶原纤维,作为慢性乙型肝炎、肝硬化纤维化程度的病理分期标准,为临床治疗提供帮助。方法方便选取2012年6月—2016年12月徐州市传染病医院病理室50例石蜡包埋肝组织切片,采用在传统Masson染色基础上进行改良的染色方法进行胶原纤维染色,根据染色结果显示慢性乙型肝炎及肝硬化肝组织中胶原纤维增生情况,作为病理诊断纤维化程度依据,染色结果与传统染色方法进行对比,并结合临床资料,判断病理诊断的分级、分期与临床诊断的分度是否一致,来评价其应用价值。结果根据患者HE染色结果和改良的Masson染色显示的胶原纤维染色结果,进行慢性肝炎病理分级、分期诊断及肝硬化诊断,50例患者中慢性乙型肝炎轻度有6例(G1-2,S1-2),慢性乙型肝炎轻-中度(G2-3、,S2-3)及中度(G3、,S3)有36例,慢性乙型肝炎重度2例(G4S2),早期肝硬化2例(G3S4),肝硬化4例,结合患者临床资料,根据染色结果作出的病理学诊断的分级、分期与患者的临床分度基本一致,有2例患者临床诊断为慢性乙型肝炎,经染色后病理诊断为肝硬化。结论改良Masson染色法与传统染色方法染色结果对比切片背景清晰,胶原纤维色泽鲜艳,对比度强,能够显示较细小的胶原纤维,染色效果更好,能满足临床病理学诊断的纤维化分期要求,具有重要的应用价值。

Objective To research a kind of modified Masson staining method used to show the collagen fibrils in liver tissue and provide help for the clinical treatment by using it as the pathological staging standards of chronic hepatitis B and liver cirrhosis fibrosis degree.Methods 50 cases of paraffin embedding hepatic tissue slices in the pathological room in our hospital from June 2012 to December 2016 were selected and dyed by collagen fibrils on the basis of the traditional Masson staining method,and the collagenous fiber hyperplasia in the chronic hepatitis B and liver cirrhosis liver tissues were showed according to the staining results,as the basis of diagnosis of fibrosis degree,and the staining method and the traditional staining method was compared and whether the pathological diagnosis grading and staging was consistent with the clinical diagnosis division were determined according to the clinical data and its application value was evaluated.Results The HE staining results and modified Masson staining results showed that in the 50 cases of patients,there were 6 cases with mild chronic hepatitis B（G1-2,S1-2）,36 cases with mild-moderate chronic hepatitis B（G2-3,,S2-3）-（G3,,S3）,2cases with severe chronic hepatitis B（G4S2）,2 cases with early liver cirrhosis（G3S4） and 4 cases with cirrhosis and the pathological diagnosis grading and staging according to the staining results was basically consistent with the clinical grading,and 2 cases were diagnosed with chronic hepatitis B and diagnosed with liver cirrhosis after dyeing.Conclusion Compared with the traditional staining method,the slice background of modified Masson staining method is clear,the color of collagen fibrils is bright,and the contrast is strong,which can show the tiny collagen fibers,and the staining effect is better,and it can meet the clinical pathological diagnosis fibrillation staging requirements with important application value.