Institute of Pathology, Freiburg University Medical Center, Freiburg, Germany.
J Clin Pathol. 2012 Nov;65(11):1013-8. doi: 10.1136/jclinpath-2012-200854. Epub 2012 Jul 26.
In bone marrow (BM) biopsies, tartrate-resistant acid phosphatase (TRAP) staining represents the gold standard for the characterisation of osteoclasts. TRAP is one of the few enzymes that is histochemically detectable on formalin-fixed paraffin-embedded tissue. This study investigated whether TRAP is also able to visualise BM osteoclasts in autopsy tissue. It was hypothesised that, due to a progressive loss of enzymatic activity in osteoclasts post-mortem, TRAP staining could allow the time of death of a patient to be determined.
TRAP-stained BM slides of 96 cases including 51 pathology and 23 forensic autopsies and 22 biopsies were histologically evaluated and their staining intensity (SI) semi-quantitatively graded. In the autopsy cases, the results were correlated with the post-mortem interval (PMI, time span in days between death and autopsy).
TRAP staining intensities (TRAP-SIs) did not differ between men and women and showed a steady decrease with age. TRAP-SIs were significantly stronger in biopsies than in autopsy cases. Among the autopsies, TRAP-SIs were highly variable and not dependent on PMI, except for three forensic cases with PMI ≥7 days which showed a complete loss of TRAP stainability. On the whole, the TRAP-SIs of pathology and forensic cases did not differ significantly.
This study clearly shows that BM osteoclasts stay TRAP-positive for 7 days post-mortem, although with markedly reduced TRAP-SIs compared with biopsies. Since TRAP-SIs were not correlated with the duration of PMI, TRAP staining of BM osteoclasts cannot serve as a tool to determine the time of death of a patient.
在骨髓（BM）活检中，抗酒石酸酸性磷酸酶（TRAP）染色是鉴定破骨细胞的金标准。TRAP 是少数几种可在福尔马林固定石蜡包埋组织中通过组织化学检测到的酶之一。本研究旨在探讨 TRAP 是否也能够在尸检组织中显示 BM 破骨细胞。研究假设，由于破骨细胞在死后酶活性逐渐丧失，TRAP 染色可能可以确定患者的死亡时间。
对 96 例病例（包括 51 例病理学和 23 例法医尸检和 22 例活检）的 BM 切片进行 TRAP 染色，对其染色强度（SI）进行半定量分级。在尸检病例中，将结果与死后间隔时间（PMI，死亡与尸检之间的天数跨度）进行相关性分析。
TRAP 染色强度（TRAP-SIs）在男性和女性之间没有差异，并随年龄的增长而稳定下降。活检中的 TRAP-SIs 明显强于尸检。在尸检中，TRAP-SIs 变化很大，与 PMI 无关，但有三个法医案例的 PMI≥7 天，显示 TRAP 染色完全丧失。总体而言，病理学和法医案例的 TRAP-SIs 没有显著差异。
本研究清楚地表明，BM 破骨细胞在死后 7 天内仍保持 TRAP 阳性，尽管与活检相比 TRAP-SIs 明显降低。由于 TRAP-SIs 与 PMI 持续时间无关，因此 BM 破骨细胞的 TRAP 染色不能作为确定患者死亡时间的工具。
