不同活检方式在供肾组织病理学评估中的比较研究

Comparative study of different biopsy methods of histopathological evaluation on donor kidney

目的研究不同的活检取材方式在供肾质量评估中的差异及其意义。方法收集2016年10月至2017年5月间经临床指标评估后弃用的6例(6对)供肾,分别通过穿刺活检和楔形活检的方式予以活检取材,采用常规组织样本固定、包埋、石蜡切片和HE染色后,从活检样本合格率、肾小球数量、硬化肾小球数量和细小动脉数量4个方面进行比较研究。结果对比观察2种活检取材方式发现,楔形活检获得样本总数为30个,其中合格样本数量为29个,合格率为96.7%;穿刺活检获得样本总数为30个,其中合格样本数量为21个,合格率为70%。楔形活检的样本中肾小球平均数量为22.1个,其中硬化肾小球平均数量为6.9个,硬化肾小球平均比例为31.3%。穿刺活检的样本中肾小球平均数量为9.5个,其中硬化肾小球平均数量为2.1个,硬化肾小球平均比例为22.1%。楔形活检获得的动脉平均数量为5.4个,穿刺活检获得的动脉数量为3.9个。采用楔形活检得到的样本合格率高于穿刺活检(P<0.01),并且楔形活检观察到的肾小球数量、硬化肾小球数量和细小动脉数量均显著高于穿刺活检(P<0.05)。结论与穿刺活检比较,楔形活检获得的供肾样本质量更好,并且在客观反映肾小球病变方面更具有优势,从组织病理学评估的角度更适于供肾质量的活检组织病理学评估。

ObjectiveTo investigate the value of different biopsy methods for quality evaluation of the donated kidney organ after citizen death. MethodsSix cases (6 pairs) of discard donor kidneys were collected from October 2016 to May 2017, respectively, and grouped by wedge biopsy and core needle biopsy. After being fixed and processed for routine paraffin embedding and hematoxylin-eosin (H&E) staining, the specimens were evaluated by the qualified rate of sample, the number of glomerulus, sclerotic glomerulus and small arteries. ResultsThe comparison of two different biopsy methods showed that the number of samples obtained by wedge biopsy was 30. There were 29 samples which were qualified and the qualification rate was 96.7%. The number of samples obtained by core needle biopsy was 30, and only 21 samples were qualified and the qualification rate was 70%. In the wedge biopsy samples, the average number of glomeruli was 22.1 and 6.9 of them were sclerotic glomeruli. The ratio of sclerotic glomeruli was 31.3%. The average number of glomeruli in core needle biopsy samples was 9.5 and 2.1 of them were sclerotic glomeruli. The ratio of sclerotic glomeruli was 22.1%. The average number of arteries in wedge biopsy samples was 5.4, and that in core needle biopsy samples was 3.9. The results indicated that the qualification rate of wedge biopsy was significantly higher than that of core needle biopsy (P<0.01). The number of glomeruli, sclerotic glomeruli and small arteries in wedge biopsy samples was significantly greater than than in core needle biopsy (P<0.05). ConclusionWedge biopsy was superior to core needle biopsy for the quality evaluation of specimens and identifying clinically significantly histopathological findings. Thus it is potential for wedge biopsy to become the main method in pre-implantation histopathological evaluation.