两种石蜡包埋肾活检组织转制电镜样品的方法比较  

A comparative study on the two methods of paraffin-embedded renal biopsy for transmission electron microscopy

作　　者：沈丽君[1] 李铎[2] 方周溪 陈朝生[2] SHEN Lijun;LI Duo;FANG Zhouxi;CHEN Chaosheng(College of Laboratory Medicine and Life Sciences,Wenzhou Medical University,Wenzhou 325035,China;Department of Nephrology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325015,China)

机构地区：[1]温州医科大学检验医学院生命科学学院,浙江温州325035 [2]温州医科大学附属第一医院肾内科,浙江温州325015

出　　处：《温州医科大学学报》2021年第5期413-417,共5页Journal of Wenzhou Medical University

基　　金：温州市科技计划项目(Y20170029,Y20170263,Y20180158)。

摘　　要：目的:比较两种不同的石蜡包埋肾活检标本转制电镜样品的方法在肾脏病理诊断中的应用价值。方法:选取2018年5月至2019年9月在温州医科大学附属第一医院肾内科进行肾脏穿刺病理诊断的患者20例。通过将每个患者的石蜡包埋组织分别经水化法处理和快速脱蜡固定法处理转制成电镜标本,分别从特征性超微结构和基底膜厚度方面与该患者的常规电镜诊断结果进行比较。结果:快速脱蜡固定法耗时更短,仅需18 h(水化法需33 h),且其对超微结构的保存优于水化法。快速脱蜡固定法和水化法与常规电镜相比均存在基底膜变薄假象(P=0.043和P<0.001),快速脱蜡固定法和水化法间基底膜厚度差异无统计学意义(P=0.210)。结论:快速脱蜡固定法和水化法这两种转制方法可用于大部分肾脏病的临床病理诊断,其中快速脱蜡固定法比水化法更具有临床应用价值。Objective:To compare the application value of two different paraffin-embedded kidney biopsy specimens transferred to electron microscopy in renal pathological diagnosis.Methods:A total of 21 patients,who underwent pathological diagnosis of renal biopsy in the Department of Nephrology of the First Affiliated Hospital of Wenzhou Medical University from May 2018 to September 2019,were enrolled in the study.The two methods of transferring paraffin-embedded tissues into transmission electron microscopy(TEM)samples were compared in aspects of characteristic ultra-structures and the thickness of glomerular basement membranes.Results:It took 18 hours,less than the time(33 h)for the normal way of dewaxing and rehydrating,to process paraffin-embedded renal biopsy samples with fast dewaxing and fixation procedure.Besides,the fast dewaxing and fixation method was more efficient in the preservation of some characteristic ultra-microstructures than the normal way of dewaxing and rehydrating.Both methods created an illusion of getting thinner in glomerular basement membrane(P=0.043,P<0.001),and there was no difference between the two transferring groups(P=0.210).Conclusion:Both methods can be used for clinical diagnosis.However,the fast dewaxing and fixation method is more suitable for clinical pathological diagnosis than the rehydrating way in that the former is better in preserving ultrastructure and short in processing time.

关 键 词：石蜡包埋 电镜 活组织检查 针吸 肾小球基底膜 

分 类 号：R692[医药卫生—泌尿科学]