Department of Nephrology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, China.
J Clin Pathol. 2013 May;66(5):374-80. doi: 10.1136/jclinpath-2012-201125. Epub 2013 Mar 9.
Immunofluorescence of frozen tissue sections (IF-F) is a traditional technique used in renal biopsy. However, IF-F has certain disadvantages, such as a few or even no glomeruli in the section, and limited long-term preservation of the fluorescently labelled samples.
We compared two-step immunohistochemistry (IHC) staining of deparaffinised sections for antigen retrieval with microwave combined high-pressure cooking to IF-F used to detect antigens of IgG, IgA, IgM, C3, C1q, κ and λ in patient renal biopsy samples. The number of glomeruli detected, sensitivity and specificity of positive staining, tissue structure, and location staining of the antigens were determined using the two methods in 285 patients diagnosed with different renal diseases.
Concordant observations between IF-F and IHC were 99% for all antigen staining (1969 of 1995 observations) and 100% for IgG, IgA and IgM (all 285 observations). The number of glomeruli in IHC sections was significantly greater compared with IF-F sections (p<0.001). IHC provided clearer images of tissue structure, more precise localisation of positive-staining antigens, and IHC staining allowed simultaneous evaluation of tissue by light microscopy. Correlation between tissue structure and immune deposits are not readily attained by IF-F.
IHC is superior to IF-F for immunopathological diagnosis of renal biopsy tissue and is a reliable replacement for the more traditional IF-F method.
冰冻组织切片免疫荧光(IF-F)是肾活检中使用的传统技术。然而,IF-F 有一定的缺点,例如切片中肾小球数量较少甚至没有,以及荧光标记样本的保存时间有限。
我们比较了两步法免疫组织化学(IHC)染色对脱蜡切片进行抗原修复,与微波联合高压煮沸相结合,用于检测 285 例不同肾脏疾病患者肾活检样本中 IgG、IgA、IgM、C3、C1q、κ 和 λ 抗原。使用这两种方法检测了 285 例患者的抗原,确定了检测到的肾小球数量、阳性染色的敏感性和特异性、组织结构以及抗原的定位染色。
IF-F 和 IHC 对所有抗原染色的一致性观察率为 99%(1969/1995 次观察),对 IgG、IgA 和 IgM 的一致性观察率为 100%(285 次观察)。与 IF-F 切片相比,IHC 切片中的肾小球数量明显更多(p<0.001)。IHC 提供了更清晰的组织结构图像,更准确的阳性染色抗原定位,并且 IHC 染色允许同时通过光学显微镜评估组织。IF-F 不易获得组织结构与免疫沉积物之间的相关性。
IHC 优于 IF-F,可用于肾活检组织的免疫病理学诊断,是更传统的 IF-F 方法的可靠替代方法。