Wagrowska-Danilewicz Małgorzata, Danilewicz Marian
Department of Nephropathology, Medical University of Lodz, Lodz.
Pol J Pathol. 2009;60(1):3-9.
The data focused on the value of immunofluorescence on paraffin-embedded sections are controversial, and it is still difficult to obtain reproducible results. The aim of our study was to evaluate the usefulness of immunofluorescence on paraffin-embedded renal section in detecting immune complex deposits in IgA nephropathy (n = 24), membranous glomerulopathy (n = 22) and lupus nephritis (n = 24). Our study revealed that direct immunofluorescence on paraffin-embedded sections pre-treated with proteinase K for 30 or 60 min is a less sensitive method than immunofluorescence on frozen sections; therefore a number of glomerulopathies may be overlooked. Immunofluorescence on paraffin sections showed dominant or co-dominant fluorescence of Riga only in 41.7% of cases of Riga nephropathy. In the studied glomerulopathies the number of positive immunofluorescences of IgA, IgG, IgM and C3 was significantly lower in immunofluorescence on paraffin sections in comparison with findings obtained from immunofluorescence on frozen sections. Irrespective of glomerular disease the rate of agreement between immunofluorescence on paraffin sections and immunofluorescence on frozen sections with respect to the presence of IgA was 56.5%, IgM - 44.4%, IgG - 73.9%, and C3 - 51.5%. In conclusion, our study revealed that immunofluorescence on paraffin sections cannot replace immunofluorescence on frozen sections in the assessment of human renal biopsies, and must be interpreted with great caution.
聚焦于石蜡包埋切片免疫荧光价值的数据存在争议，且仍难以获得可重复的结果。我们研究的目的是评估石蜡包埋肾切片免疫荧光在检测IgA肾病（n = 24）、膜性肾小球病（n = 22）和狼疮性肾炎（n = 24）中免疫复合物沉积的有用性。我们的研究表明，用蛋白酶K预处理30或60分钟的石蜡包埋切片上的直接免疫荧光是一种比冰冻切片免疫荧光敏感性更低的方法；因此一些肾小球病可能会被忽视。石蜡切片免疫荧光仅在41.7%的IgA肾病病例中显示出Riga的显性或共显性荧光。在所研究的肾小球病中，与冰冻切片免疫荧光结果相比，石蜡切片免疫荧光中IgA、IgG、IgM和C3的阳性免疫荧光数量显著更低。无论肾小球疾病如何，石蜡切片免疫荧光与冰冻切片免疫荧光在IgA存在方面的一致率为56.5%，IgM为44.4%，IgG为73.9%，C3为51.5%。总之，我们的研究表明，在评估人类肾活检时，石蜡切片免疫荧光不能替代冰冻切片免疫荧光，且必须极其谨慎地进行解读。
