苏木素-伊红及三种特殊染色方法在皮肤淀粉样变病诊断中的应用  

Application of hematoxylin-eosin and three special staining methods in the diagnosis of skin amyloidosis

作　　者：张恋 王娟 万梅 张静 游弋 杨希川 翟志芳 ZHANG Lian;WANG Juan;Wan Mei;ZHANG Jing;YOU Yi;YANG Chuanxi;ZHAI Zhifang(Department of Dermatology,the First Affiliated Hospital of the Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学附属第一医院皮肤科,重庆400038

出　　处：《检验医学与临床》2022年第S01期24-27,共4页Laboratory Medicine and Clinic

摘　　要：目的对甲基紫、刚果红、过碘酸雪夫(PAS)三种染色方法在的皮肤淀粉样变病诊断中的灵敏度和特异性进行比较。方法回顾性研究该院皮肤科病理室2017年6月1日至2019年5月31日经临床及病理确诊为皮肤淀粉样变病的102例患者临床及病理资料。所有切片均由资深皮肤病理医师共同复习阅片。首先确定HE染色淀粉样蛋白阳性率,然后将每例标本的组织石蜡标本均连续切片3张。分别用甲基紫染色、刚果红染色及PAS染色法进行染色,比较观察三种染色方法灵敏度。结果102例病理切片经HE直接镜下观察判定为阳性率52.9%(54/102);甲基紫染色阳性率为90.2%(92/102);刚果红染色阳性率为87.3%(89/102);PAS法阳性率为92.2%(94/102)。HE染色和三种特殊染色方法间比较差异均有统计学意义(P<0.01);三种特殊染色法间比较差异均无统计学意义(P>0.05)。HE染色中苔藓样型皮肤淀粉样变的阳性率明显高于和斑状型,两种类型间比较有统计学意义(P<0.05),而三种特殊染色(甲基紫、刚果红、PAS染色)中两种类型间阳性率比较差异无统计学意义(P>0.05)。结论甲基紫染色、刚果红染色和PAS染色均可有效辅助诊断皮肤淀粉样变,具有较高的灵敏度,特别是斑状型的PCA。甲基紫染色阳性率较高方法简单易行,易于推广;刚果红染色特异性较高,便于观察;PAS染色法阳性率高但结果易受干扰,特异性相对较低。因此应根据病理诊断实验室的具体条件选择合适理想的特殊染色方法。Objective To compare the sensitivity and specificity of three staining methods(methyl violet staining,congo red staining and periodic acid schiff staining)in the diagnosis of skin amyloidosis.Methods A retrospective study was conducted on 102 patients with skin amyloidosis diagnosed clinically and pathologically in the department of dermatology and pathology of the hospital from June 1,2017 to May 31,2019.All sections diagnosed as cutaneous amyloidosis were reviewed by two senior dermatopathologists.At first the positive rate of amyloidosis in HE staining was evaluated,and then three successive sections of every case were sectioned.The sensitivity and specificity of three staining methods were compared.Results With all of the 102 sections,the positive rate of HE staining was 52.9%(54/102).The positive rate of methyl violet staining was 90.2%(92/102),Congo red staining was 87.3%(89/102)and PAS method was 92.2%(94/102).There were statistically significant differences between HE staining and three special staining methods(P<0.01).There was no significant difference among the three special staining methods(P>0.05).There was statistical significance in the comparison between lichenoid type and porphyritic types in HE staining(P<0.05),while there was no statistical significance in the comparison of positive rates between the two clinical types by the three special staining(P>0.05).Conclusion Methyl violet staining,Congo red staining and PAS staining can effectively assist the diagnosis of skin amyloidosis and improve the positive rate and accuracy of PCA.All of them have a high sensitivity.Methyl violet staining is simple and easy to popularize.Congo red has high specificity and is easy to observe.while PAS staining were easily disturbed and with a relatively low specificity.Therefore,the suitable and ideal special staining method should be selected according to the specific conditions of pathological diagnosis laboratory.

关 键 词：皮肤淀粉样变病 甲基紫染色 刚果红染色 过碘酸雪夫染色 

分 类 号：R73[医药卫生—肿瘤]