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[病理学中的当前诊断]

[Current diagnosis in pathology].

作者信息

Briner J

机构信息

Institut für Klinische Pathologie, Universität Zürich.

出版信息

Schweiz Rundsch Med Prax. 1994 Jun 7;83(23):691-7.

PMID:8016509
Abstract

The introduction of modern methods into research and daily diagnostic practice of pathology has brought about major advances. In the middle of our century electron microscopy gave new insights into the ultrastructure by increasing the resolution one thousand times as compared to classical light microscopy. Immunofluorescence and histochemistry allowed assessment of functional and morphologic changes. Important new information was gained by the introduction of immunohistochemistry. The ability of antibodies to bind to epitopes even in formalin-fixed and paraffin-embedded tissues allows the precise diagnosis in many poorly differentiated tumors. The combination of different techniques (as for example immunohistochemistry and electron microscopy in the case of immuno-electronmicroscopy) lead to important new findings. The application of molecular biologic methods was a major step forward. They allow to precisely detect genomic sequences. Complementary strands are synthesized (so called probes), labelled and allowed to hybridize to the nucleic acid sequence looked for. Several examples are shown. The detection of viral nucleic acids (many of which can not reliably be identified on routine histological sections) can be achieved by in situ hybridization. The demonstration of bacteria which are slowly growing (as mycobacteria) or cannot be successfully cultivated can be easily achieved after amplification of specific nucleic acid sequences by the polymerase chain reaction. Molecular biological techniques are indispensable in cancer research (as shown here by the demonstration of IGF2 in nephroblastomas) but are also important in the diagnosis of tumors (as shown by the presence of T-cell-receptor-rearrangement in the case of suspected T-cell-lymphoma).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

现代方法引入病理学研究和日常诊断实践带来了重大进展。在本世纪中叶,电子显微镜通过将分辨率提高到经典光学显微镜的一千倍,使人们对超微结构有了新的认识。免疫荧光和组织化学能够评估功能和形态学变化。免疫组织化学的引入获得了重要的新信息。即使在福尔马林固定和石蜡包埋的组织中,抗体与表位结合的能力也使得在许多低分化肿瘤中能够进行精确诊断。不同技术的结合(例如免疫电子显微镜中免疫组织化学和电子显微镜的结合)带来了重要的新发现。分子生物学方法的应用是向前迈出的重要一步。它们能够精确检测基因组序列。合成互补链(即所谓的探针),进行标记,然后使其与目标核酸序列杂交。文中给出了几个例子。通过原位杂交可以检测病毒核酸(其中许多在常规组织学切片上无法可靠鉴定)。对于生长缓慢(如分枝杆菌)或无法成功培养的细菌,在通过聚合酶链反应扩增特定核酸序列后,很容易进行检测。分子生物学技术在癌症研究中不可或缺(如在肾母细胞瘤中检测胰岛素样生长因子2所示),但在肿瘤诊断中也很重要(如在疑似T细胞淋巴瘤中检测到T细胞受体重排所示)。(摘要截选至250字)

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