McLean C A, Beyreuther K, Masters C L
Department of Pathology, University of Melbourne, Parkville, Victoria, Australia.
Neurobiol Aging. 1997 Jul-Aug;18(4 Suppl):S89-90. doi: 10.1016/s0197-4580(97)00061-4.
The consensus recommendations for the post mortem diagnosis Alzheimer's disease (AD) highlight the difficulties in establishing a pathological diagnosis in brains from clinically demented individuals with both certainty and uniformity. There is, however, a need for diagnostic guidelines that are relatively simple, inexpensive, and adaptable to general pathologists and different laboratories. The current Consortium to Establish a Registry for Alzheimer's disease (CERAD) criteria and the recommendations in the consensus document giving three probabilistic categories for diagnosis go a long way towards establishing a uniform approach for the diagnosis of AD. However, more uniformity could be adopted in the topography of sectioning to enhance diagnostic and future research comparisons. We also recommend that immunohistochemistry for beta A4 (A beta) amyloid and tau-reactive neurofibrillary changes, in addition to hematoxylin and eosin stains, should become the basis for histological diagnosis. We agree with the guidelines concerning documentation of all AD changes. Until a clearer understanding of the early changes of AD is established, strict observation and recording are the pathologists' best diagnostic skills. The ill-defined diagnostic areas of AD continue to prompt the need for a new method of detection of the underlying pathologic process.
阿尔茨海默病（AD）尸检诊断的共识性建议强调，在临床上患有痴呆症的个体大脑中确定病理诊断，存在确定性和一致性方面的困难。然而，需要有相对简单、廉价且适用于普通病理学家和不同实验室的诊断指南。当前的阿尔茨海默病注册协会（CERAD）标准以及共识文件中给出三种诊断概率类别的建议，在很大程度上有助于建立统一的AD诊断方法。然而，在切片层面上可以采用更多的一致性，以加强诊断和未来研究的比较。我们还建议，除苏木精和伊红染色外，β淀粉样蛋白（Aβ）免疫组化和tau反应性神经纤维变化应成为组织学诊断的基础。我们同意关于记录所有AD变化的指南。在对AD的早期变化有更清晰的认识之前，严格观察和记录是病理学家最佳的诊断技能。AD诊断不明确的领域持续促使人们需要一种检测潜在病理过程的新方法。
