荧光染色法在孢子丝菌病组织病理诊断中的应用  

Application of fluorescent staining in the histopathological diagnosis of sporotrichosis

作　　者：邵也 张晓冬[2] SHAO Ye;ZHANG Xiaodong(School of Clinical Medical Sciences,Beihua University,Jilin 132011,China;Department of Dermatology,Affiliated Hospital,BeihuaUniversity,Jilin 13201l,China)

机构地区：[1]北华大学临床医学院,吉林吉林132011 [2]北华大学附属医院皮肤科,吉林吉林132011

出　　处：《临床皮肤科杂志》2024年第9期527-529,共3页Journal of Clinical Dermatology

基　　金：吉林省自然科学基金(No:20210101241JC)资助项目。

摘　　要：目的:探讨荧光染色法在孢子丝菌病组织病理切片的致病菌检测的应用价值,为孢子丝菌病的诊断提供新方法。方法:收集北华大学附属医院皮肤科就诊的疑诊孢子丝菌病患者的临床资料,取患者皮损处组织,分别进行真菌培养和组织病理学检查,对石蜡包埋组织进行平行试验,染色方法包括苏木精-伊红(HE)染色、过碘酸雪夫(PAS)染色和基膜六胺银(PASM)染色和真菌荧光染色,以真菌培养阳性为金标准,比较其阳性率和染色效果。采用SPSS 24.0软件进行统计学分析。结果:45例临床疑诊孢子丝菌病患者真菌培养阳性36例(80.00%),HE染色均为非特异性肉芽肿性改变,PAS染色阳性30例(66.67%),PASM染色阳性30例(66.67%),荧光染色阳性40例(88.89%)。由真菌培养阳性病例中染色方式与阳性率的交叉列联表及卡方检验结果可知,染色方式与阳性率存在显著的相关关系(P<0.05);9例真菌培养阴性的疑诊孢子丝菌病患者,荧光染色阳性4例,HE、PAS及PASM染色法结果均阴性。结论:荧光染色法检测孢子丝菌病患者组织切片中病原体阳性率高,具有高灵敏、高特异性的优点,可为临床诊断提供依据,具备临床应用前景。Objective:To investigate the value of using fluorescent staining in the histopathological diagnosis of sporotrichosis and to provide a new method for the diagnosis of sporotrichosis.Methods:Clinical data of patients suspected with sporotrichosis attending the Department of Dermatology of the Affiliated Hospital of Beihua University from January 2021 to December 2022 were collected,biopsies from patients'skin lesions were taken,and fungal cultures and histopathological examinations were performed,respectively.To compare the positive rate and staining efficacy,parallel tests were performed on paraffin-embedded tissues,with different staining methods including H&E,PAS,PASM and fungal fluorescence staining,using fungal culture as the gold standard.The results were statistically analyzed by using SPSS 24.0 software and 2 tests.Results:A total of 45 patients clinically suspected with sporotrichosis were enrolled,of which 36(80.00%)patients were positive for fungal culture.All cases showed non-specific granulomatous changes by H&E staining,30(66.67%)cases were positive for PAS staining,30(66.67%)cases were positive for PASM staining,and 40(88.89%)cases were positive for fluorescent staining.A cross-tabulation analysis of the staining methods and the positive detection rate in the cases with a positive fungal culture as well as the chi-square test showed that there was a significant correlation between the staining method and the positive detection rate(P<0.05).Of 9 patients suspected with sporotrichosis who had negative fungal culture,4 patients were positive by fluorescent staining,and all these patients showed negative results by H&E,PAS and PASM staining.Conclusion:The fluorescence staining method has high sensitivity and specificity in detecting pathogens in tissue sections of patients suspected with sporotrichosis,which can provide the basis for making clinical diagnosis and has good clinical application prospects.

关 键 词：荧光染色法 孢子丝菌病 诊断 真菌培养 组织病理学检查 

分 类 号：R756.6[医药卫生—皮肤病学与性病学]