Hu B J, Chen Y C, Zhu J Z
Department of Forensic Pathology, Sun Yat-sen University of Medical Sciences, Guangzhou, China.
Forensic Sci Int. 1996 Apr 23;78(3):209-17. doi: 10.1016/0379-0738(96)01891-9.
The postmortem diagnosis of early myocardial infarction has been a puzzling problem in forensic practice. In the present study, an immunohistochemical study of fibronectin (FN) was performed for the first time on 34 autopsy hearts to determine early myocardial infarction with streptavidin/biotin/peroxidase technique. Five cases of definite myocardial infarction showed positive FN staining of cardiomyocytes; of 18 cases where early myocardial infarction was suspected, positive FN staining of cardiomyocytes was found in 15 cases, but no such staining was seen in 11 non-cardiac death controls. The results led to the conclusion that positive FN staining in cardiomyocytes is a reliable marker of acute myocardial infarction and could be used as a new, sensitive method for the postmortem diagnosis of early myocardial infarction. It is worth noting that all cases in this study were autopsied between 8 h and 4 days after death and 5 cases had been fixed in 10% formalin for over 10 years. FN immunohistochemistry still gave satisfactory results in those cases. It seemed that FN was not affected by postmortem autolysis and formalin-fixation and could be used in routine forensic practice, especially for retrospective analysis of cases.
早期心肌梗死的尸检诊断在法医学实践中一直是个棘手的问题。在本研究中，首次采用链霉亲和素/生物素/过氧化物酶技术，对34例尸检心脏进行了纤连蛋白（FN）免疫组化研究，以确定早期心肌梗死情况。5例确诊心肌梗死的病例显示心肌细胞FN染色呈阳性；在18例疑似早期心肌梗死的病例中，15例心肌细胞FN染色呈阳性，而11例非心脏死亡对照中未见此类染色。结果得出结论，心肌细胞FN染色阳性是急性心肌梗死的可靠标志物，可作为早期心肌梗死尸检诊断的一种新的、敏感的方法。值得注意的是，本研究中的所有病例均在死后8小时至4天进行尸检，5例已在10%福尔马林中固定超过10年。在这些病例中，FN免疫组化仍取得了满意的结果。似乎FN不受死后自溶和福尔马林固定的影响，可用于常规法医学实践，尤其是对病例的回顾性分析。
