Paraffin immunofluorescence in the renal pathology laboratory: more than a salvage technique
Paraffin immunofluorescence in the renal pathology laboratory: more than a salvage technique
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DOI：
10.1038/modpathol.2015.1
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发表时间：
2015-06-01
期刊：
影响因子：
7.5
通讯作者：
Larsen, Christopher P.
中科院分区：
文献类型：
--
作者：
Messias, Nidia C.;Walker, Patrick D.;Larsen, Christopher P.
链霉蛋白酶消化后石蜡包埋组织的免疫荧光研究（石蜡免疫荧光）用作肾脏病理学中的挽救技术，当常规免疫荧光的冷冻组织不充分时。我们最近发现，它也是有用的，在罕见的情况下，其中的免疫沉积物是“掩盖”的常规免疫荧光，给予假阴性染色的常规免疫荧光和阳性染色的石蜡免疫荧光。本研究旨在评估石蜡免疫荧光在临床实践中的作用，重点是其实用性，以避免误诊的情况下，掩蔽免疫复合物存款。石蜡免疫荧光被用于304（6.1%）的4969个本地活检审查从我们的文件。207例（68.1%）采用石蜡免疫荧光作为挽救技术。24例（11.6%）有诊断必要，63例（30.4%）有显著贡献。石蜡免疫荧光法检测97例（31.9%）被掩盖的沉积物。在这些病例中，61例（62.9%）用于评价掩蔽的免疫复合物肾小球沉积物，36例（37.1%）用于评价掩蔽的副蛋白。在寻找免疫复合物沉积物的病例中，石蜡免疫荧光对16例（26.2%）病例的诊断是必要的，对4例（6.6%）病例的诊断有重要贡献。20例隐匿性沉积物中有14例常规免疫荧光呈C3优势染色，可能误诊为C3肾小球病。总的来说，石蜡免疫荧光是必要的，或在>1/3的病例中对诊断有显著贡献，并且在肾脏病理学中是一种有价值的技术。
Immunofluorescence studies on paraffin-embedded tissue after Pronase digestion (paraffin immunofluorescence) is used as a salvage technique in renal pathology, when frozen tissue for routine immunofluorescence is inadequate. We have recently found that it is also useful in rare cases in which the immune deposits are 'masked' on routine immunofluorescence, giving false-negative staining by routine immunofluorescence and positive staining by paraffin immunofluorescence. This study aims to evaluate the role of paraffin immunofluorescence in clinical practice with emphasis on its utility to avoid misdiagnosis of cases with masked immune complex deposits. Paraffin immunofluorescence was used in 304 (6.1%) of 4969 native biopsies reviewed from our files. In 207 (68.1%) cases, paraffin immunofluorescence was used as a salvage technique. It was necessary for diagnosis in 24 (11.6%) and had a significant contribution in 63 (30.4%) of these cases. Paraffin immunofluorescence was used to evaluate masked deposits in 97 (31.9%) cases. In 61 (62.9%) of these cases it was used to evaluate masked immune complex glomerular deposits, and in 36 cases (37.1%) it was used to evaluate masked paraproteins. Of the cases where immune complex deposits were sought, paraffin immunofluorescence was necessary for diagnosis in 16 (26.2%) cases and had a significant contribution in 4 (6.6%) cases. Fourteen of the 20 cases with masked deposits had C3 dominant stain by routine immunofluorescence, which could have been misdiagnosed as C3 glomerulopathy. Overall, paraffin immunofluorescence was necessary or had a significant contribution to diagnosis in >1/3 of the cases and is a valuable technique in renal pathology.