Polarisation microscopy increases the sensitivity of hemozoin and Plasmodium detection in the histological assessment of placental malaria
Polarisation microscopy increases the sensitivity of hemozoin and Plasmodium detection in the histological assessment of placental malaria
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DOI：
10.1016/j.actatropica.2004.02.003
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发表时间：
2004-05-01
期刊：
影响因子：
2.7
通讯作者：
Ordi, J
中科院分区：
文献类型：
--
作者：
Romagosa, C;Menendez, C;Ordi, J
胎盘的组织学研究对孕期疟疾的诊断是有用的。然而，在许多疟疾感染中缺乏寄生虫和色素，使它们难以识别。我们已经测试了标准显微镜和偏振显微镜在评估来自坦桑尼亚疟疾高流行地区的500个胎盘标本中的准确性。标准镜检显示，由于寄生虫较少的病例检出率较低（寄生红细胞< 1%为12.7%，寄生红细胞< 5%为97.8%,P < 0.001）或色素沉积极少（严重时为42.4%，严重时为84.5%,P < 0.001），灵敏度较低（寄生虫50.3%，色素40.5%）。由于在胎盘中积累的成熟阶段寄生虫中存在明显的血色素双折射，使用偏振显微镜可显着提高色素检测的灵敏度为100%，寄生虫检测的灵敏度为98.1%。福尔马林色素与血色素有许多相同的特性，但使用中性缓冲福尔马林可以防止胎盘中福尔马林色素的形成，即使经过长时间的固定。总之，极化显微镜是一种简单的工具，可以显著提高检测胎盘中疟疾感染的敏感性，并且在使用中性福尔马林固定的组织时具有良好的特异性。这种方法对疟疾领域的研究人员很有用。(C) 2004 Elsevier B.V.版权所有
The histological study of the placenta is useful in the diagnosis of malaria during pregnancy. However, the scarcity of parasites and pigment in many malarial infections renders their identification difficult. We have tested the accuracy of standard and polarisation microscopy in the evaluation of 500 placental specimens from an area of high malarial endemicity in Tanzania. Standard microscopy showed a low sensitivity (50.3% for parasites, 40.5% for pigment), due to poor detection rates in cases with scant parasites (12.7% for < 1%; 97.8% for >5% parasitised erythrocytes, P < 0.001) or minimal pigment deposition (42.4% versus 84.5% when severe, P < 0.001). The use of polarisation microscopy significantly increased the sensitivity of detection of pigment to 100% and parasites to 98.1% because of the marked birefringence of hemozoin present in mature stage parasites which accumulate in the placenta. Formalin pigment shares many properties with hemozoin, but the use of neutral buffered formalin prevented the formation of formalin pigment in placentas even after long periods of fixation. In conclusion, polarisation microscopy is a simple tool that markedly increases the sensitivity of the detection of malaria infection in the placenta and has Good specificity when used on tissues fixed in neutral formalin. This method can be useful to investigators working in the malaria field. (C) 2004 Elsevier B.V. All rights reserved.