Stuart-Smith S E, Hughes D A, Bain B J
Department of Haematology, St Mary's Hospital, Praed Street, London W2 1NY, UK.
J Clin Pathol. 2005 Mar;58(3):269-72. doi: 10.1136/jcp.2004.017038.
To determine the role of Perls' staining in bone marrow trephine biopsy sections.
The haemosiderin content of 155 Perls' stained, formic acid decalcified trephine biopsy sections was assessed and compared with Perls' stained aspirate samples in 105 cases and haematoxylin and eosin (H&E) stained biopsy sections in all cases.
An evaluable aspirate film with positive iron or at least seven negative particles was available for 105 biopsies. Only 71 of 95 cases with detectable aspirate iron had haemosiderin detectable on a Perls' stained section. None of 10 samples with a negative aspirate had a positive trephine biopsy. Haemosiderin was positive in 101 of the 155 Perls' stained sections, and was detectable on the H&E stained section in 71 of these cases. In five of 54 cases with negative Perls' staining, a small amount of haemosiderin was thought to be present on H&E staining.
Aspirate smears reflect bone marrow iron stores more reliably than formic acid decalcified trephine biopsy sections. The presence of iron in Perls' stained aspirates in 44% of cases with negative Perls' stained sections indicates that iron is often lost from sections during decalcification. However, 61% of cases with unassessable aspirate samples had a positive trephine biopsy Perls' stain, contributing useful clinical information about iron status. Preparation of Perls' stained sections only in cases in which aspirate samples are inadequate for iron assessment and no obvious haemosiderin is present in an H&E stained section could produce savings in staff time and reagent costs.
确定普鲁士蓝染色在骨髓环钻活检切片中的作用。
评估155例经甲酸脱钙并进行普鲁士蓝染色的环钻活检切片中的含铁血黄素含量，并与105例病例的普鲁士蓝染色穿刺样本以及所有病例的苏木精-伊红（H&E）染色活检切片进行比较。
105例活检中有可评估的穿刺涂片，其铁染色呈阳性或至少有七个阴性颗粒。在95例可检测到穿刺铁的病例中，只有71例在普鲁士蓝染色切片上可检测到含铁血黄素。10例穿刺阴性的样本中，环钻活检均为阴性。155例普鲁士蓝染色切片中有101例含铁血黄素呈阳性，其中71例在H&E染色切片上可检测到。在54例普鲁士蓝染色阴性的病例中，有5例在H&E染色切片上被认为存在少量含铁血黄素。
穿刺涂片比甲酸脱钙的环钻活检切片更可靠地反映骨髓铁储存情况。在普鲁士蓝染色切片阴性的病例中，44%的穿刺涂片普鲁士蓝染色呈阳性，这表明在脱钙过程中铁常从切片中丢失。然而，61例无法评估穿刺样本的病例中环钻活检普鲁士蓝染色呈阳性，提供了有关铁状态的有用临床信息。仅在穿刺样本不足以评估铁且H&E染色切片中无明显含铁血黄素的情况下制备普鲁士蓝染色切片，可节省工作人员时间和试剂成本。
