Gilani S M, Ockner D, Qu H
Pathologica. 2013 Dec;105(6):342-5.
Evaluation of kidney core biopsies ideally begins with on-site microscopic examination for adequacy and allocation of tissue for light microscopy (LM), immunofluorescence (IF) and electron microscopy (EM). However, some renal biopsies are not microscopically evaluated by a pathologist at the time of procedure, and are allocated without on-site evaluation. This study compares the actual outcome of these two techniques. We reviewed the reports of patients who underwent kidney biopsy for medical causes in the past two years. Eighty-eight biopsies had on-site microscopic evaluation by pathologists, and 70 biopsies did not undergo on-site evaluation. For biopsies without on-site evaluation, no glomeruli were seen in 5 (7.14%) cases for LM, 11 (15.71%) cases for IF and 6 (8.57%) cases for EM. In cases with on-site evaluation, the absence of glomeruli was identified in 1 (1.13%) case for LM, 3 (3.4%) for IF and 3 (3.4%) for EM. The biopsies with on-site microscopic evaluation had 5.68% of the cases considered as inadequate, while 22% of biopsies without on-site evaluation were considered inadequate. The biopsies with on-site evaluation tended to have more glomeruli obtained during the procedure (p < 0.0005). Without on-site evaluation, the likelihood of getting an inadequate specimen compared to on-site evaluation is nearly four times greater.
肾穿刺活检组织的评估理想情况下应从现场显微镜检查开始，以确定组织是否足够，并分配用于光镜检查（LM）、免疫荧光检查（IF）和电子显微镜检查（EM）。然而，一些肾活检在操作时没有由病理学家进行显微镜评估，且未经现场评估就进行了分配。本研究比较了这两种技术的实际结果。我们回顾了过去两年因医疗原因接受肾活检的患者报告。88例活检组织由病理学家进行了现场显微镜评估，70例活检组织未进行现场评估。对于未进行现场评估的活检组织，光镜检查中有5例（7.14%）未见到肾小球，免疫荧光检查中有11例（15.71%）未见到肾小球，电子显微镜检查中有6例（8.57%）未见到肾小球。在进行现场评估的病例中，光镜检查有1例（1.13%）未见到肾小球，免疫荧光检查有3例（3.4%）未见到肾小球，电子显微镜检查有3例（3.4%）未见到肾小球。进行现场显微镜评估的活检组织中有5.68%的病例被认为组织不足，而未进行现场评估的活检组织中有22%被认为组织不足。进行现场评估的活检组织在操作过程中往往能获得更多的肾小球（p<0.0005）。与现场评估相比，未进行现场评估时获得不足标本的可能性几乎大四倍。
