Lack of electron microscopy hinders correct renal biopsy diagnosis: A study from India
Lack of electron microscopy hinders correct renal biopsy diagnosis: A study from India
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DOI：
10.3109/01913123.2015.1120837
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发表时间：
2016-01-02
影响因子：
1
通讯作者：
Walker, Patrick
中科院分区：
文献类型：
--
作者：
Kurien, Anila Abraham;Larsen, Christopher;Walker, Patrick
在西方世界，电子显微镜（EM）是所有天然肾活检的常规检查。然而，在印度，由于缺乏和财政限制，没有定期进行。这项前瞻性研究的目的是评价常规对自体肾活检进行EM的有用性。为了消除选择偏倚，本研究纳入了所有连续的自体肾活检，前提是它们具有足够的组织用于光照、免疫荧光（IF）和EM。活检报告的基础上，光学和IF显微镜。由另一位病理学家对每个病例进行EM，该病理学家还独立审查了光学显微镜载玻片和IF图像。然后对这些发现进行回顾，以评估超微结构特征如何有助于初步诊断，并将其分为以下类别之一：1。诊断的关键，2。重要贡献，或3。不是必需.在评估的115例病例中，EM在12%的病例中至关重要。在20%的病例中，它提供了重要的确证性信息，在其余68%的病例中，认为不需要EM。本研究支持使用EM作为评价自体肾活检的常规诊断工具。我国迫切需要提供和获得EM。
Electron microscopy (EM) is performed routinely on all native kidney biopsies in the western world. However, in India, it is not regularly performed due to non-availability and financial constraints. The aim of this prospective study was to evaluate the usefulness of routinely performing EM on native kidney biopsies. In order to eliminate selection bias, all consecutive native kidney biopsies were included in this study, provided they had adequate tissue for light, immunofluorescence (IF), and EM. The biopsies were reported on the basis of light and IF microscopy. EM was performed on each case by another pathologist who also independently reviewed the light microscopic slides and IF images. The findings were then reviewed to assess how the ultrastructural features contributed to the primary diagnosis and assigned to one of the following categories: 1. Crucial for diagnosis, 2. Important contribution, or 3. Not required. Of the 115 cases evaluated, EM was crucial in 12% of the cases. In 20% of the cases, it provided important confirmatory information and in the remaining 68% cases, EM was not considered required. This study supports the use of EM as a routine diagnostic tool in the evaluation of native kidney biopsies. There is an urgent need for availability and accessibility of EM in our country.