Ortiz-Rey J A, Suárez-Peñaranda J M, Da Silva E A, Muñoz J I, San Miguel-Fraile P, De la Fuente-Buceta A, Concheiro-Carro L
POVISA (Policlínico de Vigo SA), Vigo, Spain.
Forensic Sci Int. 2002 Apr 18;126(2):118-22. doi: 10.1016/s0379-0738(02)00032-4.
Immunohistochemical detection of molecules involved in inflammatory reaction can be useful for the diagnosis of vitality in skin wounds. We studied the expression of fibronectin (FN) and tenascin (TN) in 58 human skin wounds (48 vital and 10 postmortem). The age of vital injuries ranged from 3 min to 8 h and postmortem specimens were collected after a postinfliction interval of 15-180 min. One hundred thirty-seven formalin-fixed paraffin-embedded sections (mean: 2.3 sections per case) were stained with each of two monoclonal antibodies against FN and TN using the streptABC technique. A reticular staining for FN in wound edge and dermis was observed in 50% of vital specimens versus 0% in postmortem cases. Immunoreactivity was reduced in 10 autolysed cases. FN positivity exclusively at the injury margin was observed in 39.4% of vital wounds and 10% of postmortem cases. TN was negative in all specimens. Vital and postmortem hemorrhage areas showed positivity for FN and TN. Due to its low sensitivity, immunohistochemical analysis of FN is useful for determining vitality only in a minority of cases. Different factors in everyday practice, including autolysis and technical problems often produce false negative reactions with the result that FN cannot be regarded as a reliable parameter of vitality. Positive reactions (network staining) are more valuable than negativity but are not pathognomonic. Both vital and postmortem hemorrhages show an enhanced positivity for FN and TN, thus impeding the diagnosis.
免疫组织化学检测炎症反应相关分子有助于诊断皮肤伤口的生机。我们研究了58例人类皮肤伤口（48例有生机伤口和10例死后伤口）中纤连蛋白（FN）和腱生蛋白（TN）的表达。有生机损伤的时间范围为3分钟至8小时，死后标本在受伤后15 - 180分钟采集。使用链霉亲和素 - 生物素 - 过氧化物酶复合物（streptABC）技术，用两种分别针对FN和TN的单克隆抗体对137张福尔马林固定石蜡包埋切片（平均：每例2.3张切片）进行染色。在50%的有生机标本中观察到伤口边缘和真皮中FN呈网状染色，而死后病例中为0%。在10例自溶病例中免疫反应性降低。在39.4%的有生机伤口和10%的死后病例中仅在损伤边缘观察到FN阳性。所有标本中TN均为阴性。有生机和死后出血区域FN和TN呈阳性。由于其低敏感性，FN的免疫组织化学分析仅在少数病例中有助于确定生机。日常实践中的不同因素，包括自溶和技术问题，常常产生假阴性反应，结果FN不能被视为生机的可靠参数。阳性反应（网状染色）比阴性反应更有价值，但并非具有诊断特异性。有生机和死后出血对FN和TN均显示增强的阳性，从而妨碍诊断。
