Mubarak Muhammed, Kazi Javed I, Kulsoom Umme, Ishaque Muhammed
Histopathology Department, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
J Nephropathol. 2012 Jul;1(2):91-100. doi: 10.5812/nephropathol.7518. Epub 2012 Jul 1.
The technique of direct immunoflourescence (IF) is essential in the accurate diagnosis of renal glomerular diseases. The optimal results are obtained when the procedure is done on fresh frozen tissue (IF-F). However, techniques are available for IF study on formalin fixed and paraffin embedded (FFPE) renal biopsy specimens with variable reported success rates.
We evaluated three such techniques on FFPE tissue and compared the results with those obtained by IF-F from the same patients.
Heat treatment with Tris buffer and citrate buffer, and pronase treatment of the FFPE material was carried out. Direct IF was done for renal panel immunoglobulins and complement components on all biopsies and the results were compared with the historical IF-F study.
When compared to the IF-F, the immunoflourescence staining on the paraffin sections was less sensitive and less intense in all immune complex-mediated renal diseases, but the diagnostic findings were detected in majority of the cases.
In conclusion, it is possible to establish the diagnosis in most cases of immune complex-mediated glomerular diseases with IF on paraffin embedded tissue specimens.
直接免疫荧光(IF)技术在肾小球疾病的准确诊断中至关重要。在新鲜冷冻组织(IF-F)上进行该操作时可获得最佳结果。然而,也有一些技术可用于对福尔马林固定石蜡包埋(FFPE)肾活检标本进行IF研究,但其报道的成功率各不相同。
我们评估了三种针对FFPE组织的此类技术,并将结果与同一患者的IF-F结果进行比较。
对FFPE材料进行Tris缓冲液和柠檬酸盐缓冲液热处理以及链霉蛋白酶处理。对所有活检标本进行肾组免疫球蛋白和补体成分的直接IF检测,并将结果与既往的IF-F研究结果进行比较。
与IF-F相比,在所有免疫复合物介导的肾脏疾病中,石蜡切片上的免疫荧光染色敏感性较低且强度较弱,但在大多数病例中均可检测到诊断结果。
总之,对于大多数免疫复合物介导的肾小球疾病病例,通过对石蜡包埋组织标本进行IF检测有可能做出诊断。