CAJ | 학술논문

目的分析3种特殊染色及免疫染色方法对区分肾淀粉样变类型的准确性、灵敏度和着色强度的影响，以提高临床的诊治水平。方法选择30例肾淀粉样变患者的病理切片，采用3种酸化刚果红染色和5种抗原修复法，对轻链蛋白（κ、λ）、淀粉样蛋白A等指标进行冰冻组织及石蜡组织的免疫荧光、免疫组化染色。使用IPP图像分析系统进行半定量分析及荧光着色半定量分析，观察比较阳性部位着色的准确性、灵敏度和着色强度效果。结果酸化甲醇刚果红染色法优于酸化Bennhold's刚果红染色法、酸化Alkaland's刚果红染色法，IPP半定量分析冰冻组织的免疫荧光、免疫组化优于石蜡组织（P=0.02）。荧光半定量分析着色强度相差一个+左右；石蜡组织暴露抗原的方法中蛋白酶K消化优于抗原热修复、胰酶或胃酶消化（P=0.01）。结论酸化甲醇刚果红染色法在肾组织淀粉样变部位的阳性着色准确性、灵敏度、着色强度和重复率均优于Bennhold's刚果红染色法、酸化Alkaland's刚果红染色法。起到初步分型及辅助验证免疫荧光染色结果的作用；进行冰冻组织轻链蛋白（κ、λ）及淀粉样蛋白A免疫荧光染色，更有利于肾淀粉样变的准确分型，如果无冰冻组织也可选用蛋白酶K消化石蜡组织免疫荧光染色。
목적분석3충특수염색급면역염색방법대구분신정분양변류형적준학성、령민도화착색강도적영향，이제고림상적진치수평。방법선택30례신정분양변환자적병리절편，채용3충산화강과홍염색화5충항원수복법，대경련단백（κ、λ）、정분양단백A등지표진행빙동조직급석사조직적면역형광、면역조화염색。사용IPP도상분석계통진행반정량분석급형광착색반정량분석，관찰비교양성부위착색적준학성、령민도화착색강도효과。결과산화갑순강과홍염색법우우산화Bennhold's강과홍염색법、산화Alkaland's강과홍염색법，IPP반정량분석빙동조직적면역형광、면역조화우우석사조직（P=0.02）。형광반정량분석착색강도상차일개+좌우；석사조직폭로항원적방법중단백매K소화우우항원열수복、이매혹위매소화（P=0.01）。결론산화갑순강과홍염색법재신조직정분양변부위적양성착색준학성、령민도、착색강도화중복솔균우우Bennhold's강과홍염색법、산화Alkaland's강과홍염색법。기도초보분형급보조험증면역형광염색결과적작용；진행빙동조직경련단백（κ、λ）급정분양단백A면역형광염색，경유리우신정분양변적준학분형，여과무빙동조직야가선용단백매K소화석사조직면역형광염색。
Objective To analyze the effect of special staining and immunohistochemical staining in distinguishing the types of renal amyloidosis to improve the diagnosis accuracy. Method Congo red staining with different methods, and immunohistochemical staining of Kappa, Lambda and Amyloid A with different antigen retrieval methods were used for staining frozen and paraffin-embedded renal tissue sections. Results Wright's Congo red staining produced a better contrast and a higher resolution and showed a greater stability than the other 2 methods after repeated use for staining the renal tissue sections (P<0.05). Immunofluorescent staining produced better results in frozen renal tissue sections than in paraffin-embedded tissues. Immunofluorescent staining produced had better performance than immunohistochemical staining in paraffin-embedded tissues. The retrieval effect with protein kinase K was the best among the antigen retrieval methods in paraffin-embedded tissues. Conclusion Wright's Congo red staining is better than the other 2 methods in diagnosing renal amyloidosis. Immunohistochemical staining of Kappa, Lambda and Amyloid A in frozen renal tissue sections is necessary to discriminate the types of renal amyloidosis. For paraffin-embedded renal tissues, antigen retrieval using protein kinase K is better than the other 2 methods.