Duston M A, Skinner M, Shirahama T, Cohen A S
Am J Med. 1987 Mar;82(3):412-4. doi: 10.1016/0002-9343(87)90439-6.
Abdominal fat aspiration samples from 443 consecutive patients were examined for amyloid after Congo red and hematoxylin staining. Of the aspirates from 83 patients known to have systemic amyloid disease prior to the biopsy, 70 (84 percent) were found to yield positive results. The results for four aspirates from patients with localized amyloid disease were negative. Of the aspirates from 356 patients of unknown clinical status referred for analysis by outside physicians, 26 (7 percent) yielded positive results for amyloid. On review of the clinical records of these 26 patients, 11 had proved systemic amyloidosis demonstrated on biopsy of another site; all had a clinical course consistent with amyloid disease. In no case was amyloid found in a fat aspiration sample from a patient without clinical evidence suggestive of systemic amyloid disease. This study supports the proposal that abdominal fat aspiration is the diagnostic procedure of choice in the evaluation of amyloidosis since it requires no specialty consultation or technical expertise, causes minimal patient discomfort, and is accompanied by virtually no risk of morbid complication. A positive result has a high predictive value of amyloid disease in patients of unknown clinical status.
对443例连续患者的腹部脂肪抽吸样本进行刚果红和苏木精染色后检查是否存在淀粉样蛋白。在活检前已知患有系统性淀粉样变性疾病的83例患者的抽吸样本中，70例（84%）结果呈阳性。4例局限性淀粉样变性疾病患者的抽吸样本结果为阴性。在由外部医生转诊进行分析的356例临床状态不明的患者的抽吸样本中，26例（7%）淀粉样蛋白检测结果呈阳性。复查这26例患者的临床记录发现，其中11例在其他部位活检时已证实患有系统性淀粉样变性；所有患者的临床病程均与淀粉样变性疾病相符。在没有临床证据提示系统性淀粉样变性疾病的患者的脂肪抽吸样本中，均未发现淀粉样蛋白。本研究支持以下提议，即腹部脂肪抽吸是评估淀粉样变性的首选诊断方法，因为它无需专科会诊或技术专长，给患者带来的不适最小，且几乎没有发生严重并发症的风险。对于临床状态不明的患者，阳性结果对淀粉样变性疾病具有较高的预测价值。
