Bodeutsch C, de Wilde P C, Kater L, van den Hoogen F H, Kruize A A, Ebben G P, Kerstens H M, van de Putte L B, Vooijs G P
Department of Pathology, University Hospital, Nijmegen, The Netherlands.
Pathol Res Pract. 1992 Jun;188(4-5):599-602. doi: 10.1016/S0344-0338(11)80063-4.
In a group of 45 patients with Sjögren's syndrome (SS) and 80 controls the high specificity (95%) and sensitivity (100%) of a recently proposed bivariate quantitative immunohistologic (QIH) criterion for SS, based on percentages of IgA and IgG-containing plasma cells in labial salivary gland (LSG) tissue, was confirmed. The best univariate QIH criterion for discrimination between LSG biopsies of SS patients and controls appeared to be based on the percentage of IgA containing plasma cells, and had a specificity of 99% and a sensitivity of 96%. A criterion based only on the percentages of IgM-containing plasma cells, proposed in another recent study, resulted in a high number (31%) of false negatives. Interobserver reproducibility of QIH diagnoses was excellent. Moreover it was demonstrated that accuracy, precision and the interobserver reproducibility of plasma cell counting depends on the choice of tissue fixation and immunohistologic staining procedure. The combination of formol sublimate fixation and peroxidase anti-peroxidase procedure appeared to be the best combination for QIH examination. Furthermore, in 2 SS patients systemic monoclonal IgM/kappa gammopathy was preceded by high predominance of IgM and kappa containing plasma cells in the plasma cellular infiltrate of the LSG tissue.
在一组45例干燥综合征（SS）患者和80例对照中，基于唇腺（LSG）组织中含IgA和IgG浆细胞的百分比，一种最近提出的用于SS的双变量定量免疫组织学（QIH）标准的高特异性（95%）和敏感性（100%）得到了证实。用于区分SS患者和对照的LSG活检的最佳单变量QIH标准似乎基于含IgA浆细胞的百分比，其特异性为99%，敏感性为96%。另一项近期研究中提出的仅基于含IgM浆细胞百分比的标准导致了大量（31%）假阴性。QIH诊断的观察者间重复性极佳。此外，还证明了浆细胞计数的准确性、精密度和观察者间重复性取决于组织固定和免疫组织学染色程序的选择。升汞甲醛固定和过氧化物酶抗过氧化物酶程序的组合似乎是QIH检查的最佳组合。此外，在2例SS患者中，系统性单克隆IgM/κ型丙种球蛋白病之前，LSG组织的浆细胞浸润中含IgM和κ的浆细胞高度占优势。
