Sen Arijit, Gupta Divya, Jagani Rajat
Senior Advisor (Pathology) & Trained in Oncopathology, Command Hospital (Air Force), Bengaluru, India.
Graded Specialist (Pathology), Base Hospital Tezpor, Assam, India.
Med J Armed Forces India. 2020 Jan;76(1):103-108. doi: 10.1016/j.mjafi.2018.12.005. Epub 2019 Apr 5.
Light chain restriction needs to be established on the paraffin embedded tissue in certain types of plasma cell dyscrasias when serum levels of monoclonal immunoglobulins and light chain assays in the urine and serum may be normal. Rapid-in-situ-hybridisation (RISH) is thought to be a superior to immunohistochemistry (IHC) for kappa and lambda staining due to brighter and crisp staining without any background.
Fifty cases were included in this pilot study. Serum light chain restriction status of the case was taken as gold standard. The results of standard IHC for kappa and lambda immunoglobulins on the bone marrow biopsy of these cases was compared with RISH performed by the two commercially available kits. The results of the two methods were compared for sensitivity, need to repeat the test and background staining.
The study found that in IHC first run sensitivity was 58% which improved to 88% after the second run. For RISH the sensitivity was 100%.
Rapid-in-situ-hybridisation (RISH) is a superior technique to IHC for detecting kappa and lambda light chain in plasma cells. The test is as labour intensive and time consuming as the routine IHC but has no background staining with more bright and crisp staining quality.
在某些类型的浆细胞异常增殖症中，当尿液和血清中的单克隆免疫球蛋白水平及轻链检测结果可能正常时，需要在石蜡包埋组织上确定轻链限制。快速原位杂交（RISH）被认为在κ和λ染色方面优于免疫组织化学（IHC），因为其染色更明亮清晰且无任何背景。
本初步研究纳入了50例病例。将病例的血清轻链限制状态作为金标准。将这些病例骨髓活检中κ和λ免疫球蛋白的标准免疫组织化学结果与两种市售试剂盒进行的快速原位杂交结果进行比较。比较两种方法在敏感性、重复检测需求和背景染色方面的结果。
研究发现，免疫组织化学首次检测的敏感性为58%，第二次检测后提高到88%。快速原位杂交的敏感性为100%。
快速原位杂交（RISH）在检测浆细胞中的κ和λ轻链方面是一种优于免疫组织化学的技术。该检测与常规免疫组织化学一样劳动强度大且耗时，但无背景染色，染色质量更明亮清晰。
