Peltier A P, Delauche M C, Cyna L, Dryll A, Ryckewaert A
Rev Rhum Mal Osteoartic. 1977 May;44(5):323-9.
The immunofluorescent study of 93 synovial membranes of persons suffering from various types of arthropathy has shown that the only element sufficiently specific to have real diagnostic value is the presence of cells with a fluorescent cytoplasm. This appearance was in fact found in 63% of the cases of rheumatoid arthritis, irrespective of their being either seropositive or seronegative, in 69% of the cases of probable rheumatoid arthritis, in only 15% of the unclassified cases of arthritis, in 28% of the cases of various types of arthritis (20% with exclusion of a case of mixed connectivitis and of a case of Waldenström's macroglobulinemia with rheumatoid arthritis) and in 0% of the cases of mechanical arthropathy. The results of immunofluorescent examination compare favorably with those of standard histology: the classical histologic appearance of rheumatoid synovitis with a node-forming tendency of the infiltrate was observed in only 36% of the verified cases of rheumatoid arthritis, while immunofluorescence was positive in 63% of the cases in this group. In the category of unclassified arthritis, these percentages were comparable, viz. 19% and 20%, repectively. The presence of cells with fluorescent cytoplasm during immunofluorescent examination of the synovial membrane may be regarded as an additional criterion supporting the diagnosis of rheumatoid arthritis.
对93例患有各种类型关节炎的患者滑膜进行的免疫荧光研究表明,唯一具有足够特异性且具有实际诊断价值的因素是存在细胞质呈荧光的细胞。事实上,在63%的类风湿性关节炎病例中发现了这种现象,无论其血清学呈阳性还是阴性;在69%的可能类风湿性关节炎病例中;在仅15%的未分类关节炎病例中;在28%的各种类型关节炎病例中(排除1例混合性结缔组织病病例和1例伴有类风湿性关节炎的瓦尔登斯特伦巨球蛋白血症病例后为20%);而在机械性关节炎病例中为0%。免疫荧光检查结果与标准组织学检查结果相比更具优势:在经证实的类风湿性关节炎病例中,只有36%观察到具有浸润结节形成倾向的类风湿性滑膜炎的经典组织学表现,而该组中63%的病例免疫荧光呈阳性。在未分类关节炎类别中,这些百分比相当,分别为19%和20%。滑膜免疫荧光检查时细胞质呈荧光的细胞的存在可被视为支持类风湿性关节炎诊断的一项额外标准。