改良荧光染色法在皮下真菌病组织病理诊断中的应用分析

Application of modified calcofluor white fluorescence staining in histopathological diagnosis of subcutaneous mycosis

目的探讨改良荧光(CFW)染色法在皮下真菌病组织病理诊断中的应用价值,为皮下真菌病的组织病理诊断提供一种新的方法。方法收集1987—2017年承德医学院附属医院收治的21例皮下真菌病患者石蜡包埋皮损组织进行平行试验,每块组织连续切片4张4μm切片,分别行改良CFW荧光染色、苏木精-伊红(HE)、过碘酸-雪夫(PAS)和六铵银(GMS)染色检查,比较其阳性率及染色效果。采用SPSS19.0软件,用卡方检验比较4种染色法在病理诊断真菌感染方面的阳性率。结果21例皮下真菌感染患者中,改良CFW荧光染色法阳性14例(66.67%),HE染色法阳性5例(23.80%),PAS染色法阳性6例(28.57%),GMS染色法阳性11例(52.38%),改良CFW荧光染色法阳性率高于HE和PAS染色法(χ^2值分别为6.718、5.200.P<0.05),而与GMS染色法阳性率差异无统计学意义(χ^2=0.693.P=0.530)。结论改良CFW荧光染色法是一种准确的真菌检查方法,在皮下真菌病的病理诊断中有一定的应用价值。

Objective To evaluate the value of modified calcofluor white fluorescent staining in the histopathological diagnosis of subcutaneous mycosis,in order to provide a new method for histopathological diagnosis of subcutaneous mycosis.Methods A total of 21 lesional skin tissues were collected from patients with subcutaneous mycosis in the Affiliated Hospital of Chengde Medical University between 1987 and 2017,and embedded in paraffin.Then,each paraffin-embedded tissue section was cut into 4 4-μm-thick serial sections,and subjected to modified calcofluor white fluorescent staining,hematoxylin and eosin (HE) staining,periodic acid Schiff (PAS) staining and Gomori methenamine silver nitrate (GMS) staining respectively.Positive rates and staining outcomes were compared among the above staining methods.Statistical analysis was carried out with SPSS 19.0 software by using chi-square test for comparing the positive rates among the above 4 staining methods.Results Of 21 patients with fungal infections,14 (66.67%) were positive for modified calcofluor white fluorescent staining,5 (23.80%) for HE staining,6 (28.57%) for PAS staining,and 11 (52.38%) for GMS staining.The positive rate by modified calcofluor white fluorescent staining was significantly higher than that by HE staining and PAS staining (χ^2 = 6.718,5.200,respectively,both P < 0.05),while no significant difference was observed between the modified calcofluor white fluorescent staining and GMS staining (χ^2 = 0.693,P = 0.530).Conclusion The modified calcofluor white fluorescent staining is an accurate method for detecting fungi,and has a certain application value in the histopathological diagnosis of subcutaneous mycosis.