Mokhtar Ghadeer A, Jallalah Sawsan M
Department of Pathology, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Iran J Kidney Dis. 2011 Sep;5(5):314-9.
Electron microscopy (EM) has been widely utilized in the evaluation of kidney biopsies. However, few recent reports have critically assessed its diagnostic value. The aim of this study is to assess the role and value of EM in the evaluation of native kidney biopsies at our institution.
A retrospective evaluation of 273 native kidney biopsies performed at our institution over 7 years was done by 2 renal pathologists in order to assess the contribution of EM to the final diagnosis in the knowledge of the light microscopy and immunofluorescence findings.
Electron microscopy had an important diagnostic contribution in 39% of cases, in 17% of which EM was essential for diagnosis. Electron microscopy was essential in the diagnosis of minimal change disease, hereditary nephritis, fibrillary glomerulonephritis, and certain classes of lupus nephritis.
In a great percentage of kidney biopsies, it was possible to make the diagnosis with certainty based on light microscopy and immunofluorescence findings alone. However, still there are numbers of cases in which EM is essentially needed to reach definitive diagnosis. Therefore, at least a piece of tissue should be kept for EM in appropriate fixative in each case, which could then be performed at the discretion of the pathologist.
电子显微镜（EM）已广泛应用于肾活检评估。然而，近期很少有报告对其诊断价值进行批判性评估。本研究的目的是评估EM在我院对原发性肾活检评估中的作用和价值。
2名肾脏病理学家对我院7年间进行的273例原发性肾活检进行回顾性评估，以便在了解光镜和免疫荧光检查结果的基础上，评估EM对最终诊断的贡献。
电子显微镜在39%的病例中具有重要诊断作用，其中17%的病例中EM对诊断至关重要。电子显微镜在微小病变性肾病、遗传性肾炎、纤维性肾小球肾炎及某些类型的狼疮性肾炎的诊断中至关重要。
在很大比例的肾活检中，仅根据光镜和免疫荧光检查结果就有可能做出明确诊断。然而，仍有许多病例需要EM才能得出明确诊断。因此，每例至少应保留一块组织用适当固定剂固定以备EM检查，然后由病理学家酌情进行检查。
