Grönhagen-Riska C, von Willebrand E, Honkanen E, Laasonen L, Törnroth T
IVth Department of Medicine, Helsinki University Central Hospital, Finland.
Clin Nephrol. 1990 Nov;34(5):189-96.
Fine-needle aspiration biopsy (FNAB) was used to detect renal mononuclear interstitial inflammation in 56 patients with various types of nephritis (20 IgA nephropathy, 8 focal necrotizing glomerulonephritis, 7 interstitial nephritis, 6 non-classifiable chronic glomerulonephritis, 5 mesangial proliferative (non-IgA) chronic glomerulonephritis, 4 focal glomerulosclerosis, 6 normal histology, who were examined for microscopic hematuria, and 7 controls). Regular renal biopsies for histological and immunofluorescence studies were simultaneously obtained, and available for comparative analysis (not controls). Differential counts of mononuclear infiltration and subtyping of T-cell infiltration into T-helper (T-h) and T-suppressor-cytotoxic (T-s-c) cells, as detected by immunoperoxidase stains from FNAB, were correlated to clinical manifestations and renal function tests. Generally, our results indicated increased mononuclear cell infiltration (monocytes, lymphocytes, and/or activated lymphocytes) in FNAB of patients with IgA nephropathy, interstitial nephritis or focal necrotizing glomerulonephritis (especially monocytes in IgA nephropathy and interstitial nephritis, p less than 0.05 compared with controls, lymphocytes in focal necrotizing glomerulonephritis, and non-classifiable glomerulonephritis, p less than 0.02 and 0.05, respectively). The number of infiltrating activated lymphocytes was significantly increased in focal necrotizing glomerulonephritis, interstitial nephritis and focal glomerulosclerosis, p less than 0.05, less than 0.01 and less than 0.01, respectively. FNAB was at least as sensitive as histological examination for the quantification of interstitial cellular infiltration, and it allowed for cytological differential counts. Patients had decreased T-h and increased T-s-c cell counts, which were accentuated in FNAB compared with peripheral blood, although there were strong positive correlations between local and peripheral counts (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
采用细针穿刺活检（FNAB）对56例各类肾炎患者（20例IgA肾病、8例局灶坏死性肾小球肾炎、7例间质性肾炎、6例无法分类的慢性肾小球肾炎、5例系膜增生性（非IgA）慢性肾小球肾炎、4例局灶节段性肾小球硬化、6例因镜下血尿接受检查且组织学正常者以及7例对照者）的肾单核细胞间质炎症进行检测。同时获取用于组织学和免疫荧光研究的常规肾活检样本，以便进行对比分析（对照者除外）。通过FNAB免疫过氧化物酶染色检测到的单核细胞浸润差异计数以及T细胞浸润亚型（辅助性T细胞（T-h）和抑制性细胞毒性T细胞（T-s-c））与临床表现和肾功能检查相关。总体而言，我们的结果表明，IgA肾病、间质性肾炎或局灶坏死性肾小球肾炎患者的FNAB中单核细胞浸润增加（单核细胞、淋巴细胞和/或活化淋巴细胞）（尤其是IgA肾病和间质性肾炎中的单核细胞，与对照相比p<0.05；局灶坏死性肾小球肾炎和无法分类的肾小球肾炎中的淋巴细胞，p分别<0.02和0.05）。局灶坏死性肾小球肾炎、间质性肾炎和局灶节段性肾小球硬化中浸润的活化淋巴细胞数量显著增加，p分别<0.05、<0.01和<0.01。在间质细胞浸润定量方面，FNAB至少与组织学检查一样敏感，并且能够进行细胞学差异计数。患者的T-h细胞计数减少，T-s-c细胞计数增加，与外周血相比，FNAB中更为明显，尽管局部和外周计数之间存在强正相关（p<0.0001）。（摘要截选至250字）
