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[鼻窦真菌球的免疫组织化学诊断]

[Immunohistochemical diagnosis of fungus ball in paranasal sinuses].

作者信息

Li Yuan, Yang Da-zhang, Pan Lin, Liu Dan-dan, Zhang Xiao-bo

机构信息

Department of Otorhinolaryngology, Beijing Sino-Japan Friendship Hospital, Beijing 100029, China.

出版信息

Zhonghua Er Bi Yan Hou Ke Za Zhi. 2004 Sep;39(9):546-8.

Abstract

OBJECTIVE

To study the pathogens of fungus balls in paranasal sinuses and establish an immunohistochemical test by which the main opportunistic fungi could be identified.

METHODS

Twenty-five patients with fungal balls were treated by surgical removal of the fungus ball in the infected sinuses. The pathogenic fungi on the specimens were identified by means of routine PAS and immunohistochemical staining methods, and the sensitivity of the two methods were compared.

RESULTS

The most commonly infected sinus was the maxillary sinus, followed by sphenoid sinus. Pathogens of fungal balls were found to be aspergillus (92%, 23/25) and candida 2 cases (8%). Aspergillus and candida albicans in infected sinuses could be specifically identified by immunostainning. There was no statistically significant differences of sensitivity between immunostainning and PAS stain.

CONCLUSIONS

The main pathogen of the fungus ball was aspergillus. Immunostainning was a rapid and reliable method to identify fungi in infected tissues of paranasal sinuses. It should be widely used in the diagnosis of fungal sinusitis.

摘要

目的

研究鼻窦真菌球的病原菌,并建立一种可识别主要机会性真菌的免疫组织化学检测方法。

方法

对25例真菌球患者行手术切除感染鼻窦内的真菌球。采用常规过碘酸雪夫(PAS)染色法和免疫组织化学染色法对标本中的致病真菌进行鉴定,并比较两种方法的敏感性。

结果

最常感染的鼻窦是上颌窦,其次是蝶窦。真菌球的病原菌以曲霉菌为主(92%,23/25),念珠菌2例(8%)。免疫染色可特异性识别感染鼻窦内的曲霉菌和白色念珠菌。免疫染色与PAS染色的敏感性差异无统计学意义。

结论

真菌球的主要病原菌是曲霉菌。免疫染色是一种快速、可靠的识别鼻窦感染组织中真菌的方法,应广泛应用于真菌性鼻窦炎的诊断。

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