Challa V R, Moran J R, Turner C S, Lyerly A D
Am J Clin Pathol. 1987 Sep;88(3):324-8. doi: 10.1093/ajcp/88.3.324.
False positive and negative results can complicate the diagnosis of Hirschsprung's disease (HD) with the acetylcholinesterase (AChE) stain. To improve the diagnostic value of this test, the authors evaluated the concurrent hematoxylin and eosin (H and E) staining of extra sections after the AChE procedure. Flash-frozen (FF), cryostat-cut (CC) sections of rectal suction biopsies from 96 patients with constipation were evaluated by AChE together with H and E staining of additional unstained sections. In 13 of 15 cases of HD with a diagnostic (positive-A) AChE pattern, the H and E sections confirmed the diagnosis. In five cases with other AChE patterns, the H and E sections were instrumental when the diagnosis was made. Of the 76 non-HD subjects with positive-B (n = 8), equivocal (n = 6), and negative (n = 62) AChE patterns, the H and E sections eliminated the diagnosis in 62 (81%). Neuronal and nerve fiber morphologic characteristics were excellent. Rebiopsies were needed in 14 subjects (19%) when there was failure in finding neurons. Simplicity, quickness, and the high quality of the histologic preparations make this procedure a useful adjunct to the AChE stain.
假阳性和假阴性结果会使乙酰胆碱酯酶（AChE）染色诊断先天性巨结肠（HD）变得复杂。为提高该检测的诊断价值，作者评估了AChE检测后额外切片同时进行的苏木精和伊红（H&E）染色。对96例便秘患者直肠吸引活检的速冻（FF）、低温恒冷切片机切片（CC）进行AChE检测，并对额外未染色切片进行H&E染色评估。在15例诊断性（阳性-A）AChE模式的HD病例中，有13例H&E切片证实了诊断。在5例其他AChE模式的病例中，诊断时H&E切片起到了作用。在76例AChE模式为阳性-B（n = 8）、可疑（n = 6）和阴性（n = 62）的非HD受试者中，H&E切片排除了62例（81%）的诊断。神经元和神经纤维的形态特征良好。14名受试者（19%）在未能找到神经元时需要重新活检。该方法操作简单、快速，组织学制片质量高，是AChE染色的有用辅助手段。
