Dardik M, Epstein J I
Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Hum Pathol. 2000 Sep;31(9):1155-61. doi: 10.1053/hupa.2000.17989.
Prostate tissue and lesions obtained by needle biopsy may be scant and not survive cutting into the block; this study examined the efficacy of destaining hematoxylin and eosin-stained sections and restaining the slides using immunohistochemistry with high-molecular weight cytokeratin (high-molecular weight cytokeratin). We identified 105 prostate needle biopsies referred to Johns Hopkins Hospital in an 18-month period (January 1997-June 1998) that had been destained and restained for high molecular weight cytokeratin. The slides were reviewed for the Johns Hopkins Hospital diagnosis (benign, malignant, or equivocal), which had factored in the immunohistochemistry results, and for immunohistochemistry staining quality (optimal, suboptimal, stain failed, or lesion fell off). We obtained data on 96 cases from the referring institutions about the fixative and glass slides used for processing the needle biopsy. In 58% of cases, destaining and restaining with high-molecular weight cytokeratin allowed a definitive benign or malignant diagnosis to be made; in 79% of these cases, the staining was optimal. In only 13% of cases the diagnosis remained equivocal; of these, the stain worked optimally in only 36%. In 19% of cases, the stain failed. In 9% of cases, the lesion fell off; in all 7 cases with available data the tissue had been cut on non-charged slides. All but 3 cases were received in 10% neutral buffered formalin. There was no correlation between the use of charged (plus or lysine coated) or non-charged slides and the staining quality. Furthermore, in 12 instances, we received more than 1 specimen from the same referring institution, and in 6 of these instances there was variable staining in the different cases from the same institution. Destaining hematoxylin and eosin-stained slides and restaining for high-molecular weight cytokeratin is a useful technique that in the majority of cases enables a definitive diagnosis to be made. Tissue may survive the procedure better if originally cut on charged slides, but staining quality is no different for charged or non-charged slides.
通过针吸活检获得的前列腺组织和病变可能很少，且在切成组织块后无法留存；本研究检测了苏木精和伊红染色切片脱色，并使用高分子量细胞角蛋白进行免疫组化重新染色的效果。我们确定了在18个月期间（1997年1月至1998年6月）转诊至约翰·霍普金斯医院的105例前列腺针吸活检病例，这些病例已进行了高分子量细胞角蛋白的脱色和重新染色。对这些切片进行复查，以确定约翰·霍普金斯医院的诊断结果（良性、恶性或不明确），该诊断已考虑了免疫组化结果，同时复查免疫组化染色质量（最佳、次优、染色失败或病变脱落）。我们从转诊机构获得了96例病例中关于用于处理针吸活检的固定剂和载玻片的数据。在58%的病例中，高分子量细胞角蛋白脱色和重新染色后可做出明确的良性或恶性诊断；在这些病例中，79%的染色为最佳。仅13%的病例诊断仍不明确；其中，染色效果最佳的仅占36%。19%的病例染色失败。9%的病例病变脱落；在所有7例有可用数据的病例中，组织均是在未带电荷的载玻片上切割的。除3例病例外，所有病例均用10%中性缓冲福尔马林固定。使用带电荷（正电荷或赖氨酸包被）或不带电荷的载玻片与染色质量之间无相关性。此外，在12例中，我们从同一转诊机构收到了不止1份标本，其中6例来自同一机构的不同病例染色情况不同。苏木精和伊红染色切片脱色并进行高分子量细胞角蛋白重新染色是一项有用的技术，在大多数情况下能够做出明确诊断。如果最初在带电荷的载玻片上切割，组织在该过程中可能留存得更好，但带电荷或不带电荷的载玻片染色质量并无差异。
