黏蛋白乳化剂在1418例细胞蜡块制备技术中的应用研究

Application of mucin emulsifier in the preparation of 1418 cell wax blocks

目的探讨黏蛋白乳化剂制备的1418例非妇科细胞蜡块的苏木素伊红(HE)染色、免疫组织化学(IHC)染色的效果和诊断价值。方法收集2018年7月至2022年1月该院送检的1418例细胞学标本,离心,弃上清液,加入甲醛-乙醇(AF)液5 mL,黏蛋白乳化剂250μL,混匀,离心,弃上清液,取出沉淀细胞块放入包埋盒,按照常规石蜡切片制备程序进行固定、脱水、透明、包埋、切片和HE染色,对细胞块病理诊断为恶性的285例标本,切2138张片进行IHC染色检测,观察黏蛋白乳化剂制备的细胞块及切片的外观大体情况;探讨细胞块切片HE染色和IHC染色的显微镜下情况和切片优良率;以患者术后病理诊断结果为金标准,综合评估黏蛋白乳化剂制备的细胞块的诊断效能。结果(1)黏蛋白乳化剂制备的细胞块制作成功率是100.00%,细胞块外观呈圆形果冻样胶体的结构、细胞聚集成团、硬度适中。细胞块切片外观完整、呈规则的圆形结构、疏松度适中。(2)细胞块可连续均匀切片,HE染色背景清晰,核浆着色鲜艳,红蓝分明,对比清晰,细胞均匀分布于圆形区域内,细胞形态呈现立体感,细胞块切片厚薄均一,IHC染色背景干净,结构和细胞均呈特异性染色。(3)细胞块的HE染色切片优良率为98.94%;IHC染色切片优良率为99.30%。(4)细胞块诊断的灵敏度、特异度、符合率和约登指数分别是96.94%、100.00%、99.37%、0.9694。结论黏蛋白乳化剂制备细胞块的技术操作便捷,成本低,富集率高,形态好,细胞块石蜡切片可长期保存,其HE染色和IHC染色优良率高,具有良好的诊断效能,应用前景广阔。

Objective To investigate the effect and diagnostic value of hematoxylin eosin(HE)staining and immunohistochemical(IHC)staining of 1418 cases of non gynecological cell wax prepared by mucin emulsifier.Methods One thousand four hundred and eighteen cytological samples submitted by Foshan Hospital of traditional Chinese medicine from July 2018 to January 2022 were collected,centrifuged,discarded the supernatant,added 5 mL of formaldehyde alcohol(AF)solution and 250μL of mucin emulsifier,mixed,centrifuged,discarded the supernatant,took out the precipitated cell block,put it in the embedding box,fixed,dehydrated,transparent,embedded,sliced and he stained according to the routine paraffin section preparation procedure and 285 samples with malignant pathological diagnosis of cell block were analyzed,2138 slices were cut for IHC staining.Observe the appearance of cell blocks and sections prepared by mucin emulsifier.To investigate the microscopical condition of HE staining and IHC staining of cell block sections and the excellent and good rate of sections.The diagnostic efficacy of cell mass prepared by mucin emulsifier was comprehensively evaluated based on the results of postoperative pathological diagnosis.Results(1)The success rate of cell block prepared by mucin emulsifier is 100.00%,The appearance of the cell block is a round jelly like colloidal structure,the cells gather into clusters and the hardness is moderate.The appearance of cell block section is complete,with regular circular structure and moderate porosity.(2)The cell block can be sectioned continuously and evenly.The HE staining background is clear,the nucleoplasm is brightly colored,the red and blue are clear and the contrast is clear.The cells are evenly distributed in the circular area.The cell morphology presents a three-dimensional sense.The thickness of the cell block section is uniform,the IHC staining background is clean and the structure and cells show specific staining.(3)The excellent and good rate of HE staining section of cell block was 98.94%;The excellent and good rate of IHC staining section was 99.30%.(4)The sensitivity,specificity,coincidence rate and yoden index of cell block diagnosis were 96.94%,100.00%,99.37%and 0.9694 respectively.Conclusion The technology of preparing cell block with mucin emulsifier has the advantages of convenient operation,low cost,high enrichment rate and good shape.The paraffin section of cell block can be preserved for a long time.Its excellent rate of HE and IHC staining are high,which have good diagnostic efficiency and broad application prospect.