细胞蜡块制作方法改良及在浆膜腔积液临床病理分析中的应用  

Modification for method of paraffin-embedded cell block preparation and its applica-tion in clinicopathological analysis of serous effusion

作　　者：王莉莉 段海瑞 敖启林[3] Wang Lili;Duan Hairui;Ao Qilin(Department of Pathology,Daye 435100;Department of Oncology,Daye People’s Hospital,Daye 435100;Institute of Pathology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030)

机构地区：[1]大冶市人民医院病理科,大冶435100 [2]大冶市人民医院肿瘤科,大冶435100 [3]华中科技大学同济医学院附属同济医院病理研究所,武汉430030

出　　处：《中国组织化学与细胞化学杂志》2020年第4期364-368,共5页Chinese Journal of Histochemistry and Cytochemistry

摘　　要：目的研究并分析浆膜腔积液经多次反复离心及加固定液离心制作成细胞蜡块的成功率,并结合相关免疫细胞化学染色以验证其诊断的价值。方法选取临床怀疑恶性胸腹水的患者30例,胸腹水标本接收后放置半小时,倒掉部分上清液,剩余液体分批多次转移至同一个10 ml离心管中离心5min,2000 r/min、弃上清(一般反复转移离心5次),再加入10%的中性甲醛,2000 r/min离心5min,弃上清,此时细胞沉渣已经成小块状,取出块状细胞用滤纸包裹,装入包埋盒,放入10%的中性甲醛固定1h,然后脱水、浸蜡、包埋,制作成细胞蜡块、切片、HE染色。镜下观察细胞形态学,并结合相关的免疫细胞化学染色标记,确定胸腹水的性质及细胞来源。结果通过对细胞蜡块制作过程的改良,30例胸腹水细胞蜡块制作成功率达到100%,结合免疫细胞化学检测,对胸腹水的诊断率达到100%,且简单、经济、实用性强。结论通过对细胞蜡块制作过程的改良,并结合相关的免疫细胞化学染色检查有助于诊断晚期难以取得病理活检组织的浆膜腔积液的性质及来源,尤其针对基层病理科而言,该方法既实用又经济,值得推广。Objective To study and analyze the success rate of making paraffin-embedded cell blocks from serous effusion by repeated centrifugation and centrifugation with fixative,and to verify its diagnostic value in combination with relevant immunocyto-chemical staining.Methods 30 patients with clinically suspected malignant pleural effusion and/or ascites were selected.When the pleural effusion and ascites samples were placed half an hour after receipt,part of the supernatant was discarded.The remaining liquid was transferred to the same 10 ml centrifuge tube in batches for centrifugation for 5 min,2000 r/min,and the supernatant was discarded each time(generally reverse transfer centrifugation for 5 times),and then 10%neutral formaldehyde was added,centrifuged at 2000 r/min for 5 min,and the supernatant was discarded.At this time,the cell sediment had become small lumps.The lumpy cells were taken out,wrapped with filter paper,loaded into an embedding cassette,and fixed in 10%neutral formaldehyde for 1 hour.Then they were dehydrated,immersed in wax,embedded,and prepared into cell blocks,sections,and HE staining subsequently.The cell morphology was observed and combined with the relevant immunocytochemical staining markers to determine the nature of pleural effusion and ascites and the source of cells.Results The success rate of paraffin-embedded cell blocks preparation in 30 cases of pleural effusion and ascitic reached 100%through the modification.Combined with immunocytochemical detection,the diagnostic rate of pleural effusion and ascitic reached 100%,and the modification was simple,economical and practical.Conclusion The modification of the process of paraffin-embedded cell blocks preparation combined with the relevant immunocytochemical staining examination is helpful for the diagnosis of the nature and source of serosal effusion from the cases in the late stage which are difficult to obtain the pathological biopsy tisssues, especially for the local department of pathology without high-tech equipment, this method is

关 键 词：浆膜腔积液 细胞蜡块 免疫细胞化学染色 

分 类 号：R-33[医药卫生]