快速石蜡切片与冷冻切片在供器官组织病理学评估中的比较研究  

Comparative study of rapid paraffin section versus frozen section of histopathological evaluations of donor organ

作　　者：陈剑霖 王心强[1] 徐晶[1] 蒋继贫[1] 陈刚[1] 郭晖[1] Chen Jianlin;Wang Xinqiang;Xu Jing;Jiang Jipin;Chen Gang;Guo Hui(Institute of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Key Laboratory of Organ Transplantation,Ministry of Education,Key Laboratory of Organ Transplantation,National Health Commission,Key Laboratory of Organ Transplantation,Chinese Academy of Medical Sciences,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院器官移植研究所,器官移植教育部重点实验室,国家卫生健康委员会器官移植重点实验室,中国医学科学院器官移植重点实验室,武汉430030

出　　处：《中华器官移植杂志》2021年第11期641-645,共5页Chinese Journal of Organ Transplantation

基　　金：中国医学科学院中央级公益性科研院所基本科研业务费专项资金(2019PT320014);华中科技大学自主创新基金(01-08-540149)。

摘　　要：目的探究快速石蜡切片较之冷冻切片在器官捐献供器官的组织病理学评估中的优劣。方法收集2017年至2021年间华中科技大学同济医学院附属同济医院器官移植研究所的5例供肝标本和8例弃用供肾标本, 对供器官活检组织分别采用冷冻切片、快速石蜡切片和常规石蜡切片方法制片, 经苏木精-伊红染色后, 从供肾和供肝镜下的基本形态以及相关供器官评分的差异方面进行比较。结果快速石蜡切片在反映肾小球硬化比例(18.6%±22.3%)、小动脉透明样变(43.7%±23.8%)和小动脉狭窄(47.9%±29%)方面与常规石蜡切片相似。冰冻切片中观察到的肾小球硬化比例(0.8%±2.2%)、小动脉透明样变比例(4.9%±7.4%)和小动脉狭窄(5.3%±7.5%)比例均低于快速石蜡切片。另外快速石蜡切片对肝细胞坏死和水变性的判断也更为准确。结论快速石蜡切片较冷冻切片镜下组织结构更清晰、完整。在评分方面能更准确地反映供器官的组织病理学改变。Objective To explore the advantages and disadvantages of frozen section versus rapid paraffin section in the evaluations of donor organ.Methods Five cases of donor liver and 8 cases of discarded donor kidney were collected from 2017 to 2021.Tissues were harvested and prepared by frozen section,rapid paraffin section and normal paraffin section.After hematoxylin-eosin(H&E)staining,the specimens of donor kidney/liver were evaluated by differential histopathological structures and donor quality scoring system.Results Rapid paraffin section was similar to normal paraffin section in reflecting the proportion of glomerulosclerosis(18.6%±22.3%),arteriolar hyaline degeneration(43.7%±23.8%)and arteriolar stenosis(47.9%±29%).The proportion of glomerulosclerosis(0.8%±2.2%),arteriolar hyaline degeneration(4.9%±7.4%)and arteriolar stenosis(5.3%±7.5%)were lower in frozen sections than those in rapid paraffin sections.The diagnoses of hydropic degeneration and necrosis in donor liver were more accurate in rapid paraffin section.Conclusions Rapid paraffin section is superior to frozen section in observing histopathological changes under microscope.Scoring of donor organ is more precise according to rapid paraffin section.

关 键 词：供器官 组织病理学 冷冻切片术 石蜡切片 

分 类 号：R361.2[医药卫生—病理学]