Schimanski Tom, Loucas Rafael, Loucas Marios, Felthaus Oliver, Brébant Vanessa, Klein Silvan, Anker Alexandra, Frank Konstantin, Siegmund Andreas, Pagani Andrea, Geis Sebastian, Diesch Sophia Theresa, Eigenberger Andreas, Prantl Lukas
Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany.
Clinic of Plastic, Aesthetic, and Reconstructive Surgery, Döbling Private Hospital, 1090 Vienna, Austria.
Cells. 2025 Jun 14;14(12):898. doi: 10.3390/cells14120898.
Histological and immunohistochemical analyses of adipose tissue are essential for evaluating the quality and functionality of lipoaspirates in regenerative medicine and fat grafting procedures. These methods provide insights into tissue viability, cellular subtypes, and extracellular matrix (ECM) composition-all factors influencing graft retention and clinical outcomes.
This scoping review aims to summarize the most commonly used staining methods and their applications in the histology and immunohistochemistry of adipose tissue. By exploring qualitative and quantitative markers, we seek to guide researchers in selecting the appropriate methodologies for addressing experimental and translational research.
A systematic search was conducted using PubMed, Ovid, and the Cochrane Library databases from inception to 2024, employing Boolean operators ("lipoaspirate" OR "fat graft" OR "gauze rolling" OR "decantation" OR "coleman fat" OR "celt" OR "nanofat" OR "lipofilling" OR "human fat" AND "histol*"). Studies were included if they utilized histology or immunohistochemistry on undigested human adipose tissue or its derivatives. The inclusion criteria focused on peer-reviewed, English-language studies reporting quantitative and qualitative data on adipose tissue markers.
Out of 166 studies analyzed, hematoxylin-eosin (H&E) was the most frequently employed histological stain (152 studies), followed by Masson Trichrome and Sudan III. Immunohistochemical markers such as CD31, CD34, and perilipin were extensively used to distinguish stromal vascular fraction (SVF) cells, adipocytes, and inflammatory processes. Studies employing semiquantitative scoring demonstrated enhanced comparability, particularly for fibrosis, necrosis, and oil cyst evaluation. Quantitative analyses focused on SVF cell density, mature adipocyte integrity, and ECM composition. Methodological inconsistencies, particularly in preparation protocols, were observed in 25 studies.
This review highlights the critical role of histological and immunohistochemical methods in adipose tissue research. H&E staining remains the cornerstone for general tissue evaluation in the clinical context, while specialized stains and immunohistochemical markers allow for detailed analyses of specific cellular and ECM components in experimental research. Standardizing preparation and evaluation protocols will enhance interstudy comparability and support advancements in adipose tissue-based therapies.
脂肪组织的组织学和免疫组织化学分析对于评估再生医学和脂肪移植手术中脂肪抽吸物的质量和功能至关重要。这些方法有助于深入了解组织活力、细胞亚型和细胞外基质（ECM）组成，所有这些因素都会影响移植的留存率和临床结果。
本范围综述旨在总结脂肪组织组织学和免疫组织化学中最常用的染色方法及其应用。通过探索定性和定量标记物，我们旨在指导研究人员选择合适的方法来开展实验性和转化性研究。
使用PubMed、Ovid和Cochrane图书馆数据库从建库至2024年进行系统检索，采用布尔运算符（“脂肪抽吸物”或“脂肪移植”或“纱布滚动”或“倾析法”或“科尔曼脂肪”或“塞尔特”或“纳米脂肪”或“脂肪填充”或“人脂肪”且“组织学*”）。如果研究对未消化的人脂肪组织或其衍生物进行了组织学或免疫组织化学研究，则纳入该研究。纳入标准侧重于报告脂肪组织标记物定量和定性数据的同行评审英文研究。
在分析的166项研究中，苏木精-伊红（H&E）是最常用的组织学染色方法（152项研究），其次是马森三色染色法和苏丹III染色法。免疫组织化学标记物如CD31、CD34和 perilipin被广泛用于区分基质血管成分（SVF）细胞、脂肪细胞和炎症过程。采用半定量评分的研究显示可比性增强，尤其是在纤维化、坏死和油囊肿评估方面。定量分析侧重于SVF细胞密度、成熟脂肪细胞完整性和ECM组成。在25项研究中观察到方法学上的不一致，特别是在制备方案方面。
本综述强调了组织学和免疫组织化学方法在脂肪组织研究中的关键作用。H&E染色仍然是临床环境中一般组织评估的基石，而特殊染色和免疫组织化学标记物则允许在实验研究中对特定细胞和ECM成分进行详细分析。标准化制备和评估方案将提高研究间的可比性，并支持基于脂肪组织的治疗方法的进展。
