冷冻与石蜡肾活检标本中PLA2R1表达的临床诊断意义比较

目的探讨磷脂酶A2受体1(PLA2R1)在肾脏穿刺的冷冻标本及石蜡标本中的表达,分析不同标本中阳性率的临床病理诊断意义。方法收集2013年1月~2019年2月江门市中心医院行肾脏穿刺患者的标本及临床病理资料,其中同时有肾活检冷冻标本及石蜡标本的患者215例,仅有石蜡标本的患者785例。分别利用免疫荧光及免疫组化法检测PLA2R1在肾活检冷冻和石蜡标本中的表达,并分析PLA2R1表达与临床病理特征的相关性。结果在215例冷冻标本中,PLA2R1阳性率为19.1%;在1000例石蜡标本中,PLA2R1阳性率为32.9%,两组中PLA2R1的阳性率差异有统计学意义(P<0.001)。在冷冻和石蜡标本中,PLA2R1表达与患者性别、年龄及临床分期无关,与病理类型相关。在冷冻和石蜡标本中,PLA2R1阳性均集中于特发性膜性肾病(72.0%和79.8%),但非特发性膜性肾病中,则分别为3.0%和19.4%。结论肾活检冷冻及石蜡标本中PLA2R1表达均与特发性膜性肾病相关,但冷冻标本在特发性膜性肾病诊断中更有价值。

Evaluation the clinical value of PLA2R1 expression levels in renal biopsy tissue by freezing or paraffin-embedding

Purpose To evaluate the application and clinical value of phospholipase A2 receptor 1(PLA2R1)expression levels in renal biopsy tissue by freezing or paraffin-embedding.Methods Renal biopsy tissue and information of patients with nephropathy from January 2013 to February 2019 in the Jiangmen Central Hospital were collected.There are 215 patients with renal biopsy tissue both by freezing or paraffin-embedding,and 785 patients with renal biopsy tissue only by paraffin-embedding.The PLA2R1 expression level was analysis by immunofluorescence staining in frozen renal biopsy tissue,and detected by immunohistochemistry staining in paraffin-embedded renal biopsy tissue.The correlated with patients’clinical and pathological characteristics were analyzed by Chi-squared test.Results In 215 frozen renal biopsy tissue,the positive rate of PLA2R1 was 19.1%,while the positive rate of PLA2R1 was 32.9%in 1000 paraffin-embedded renal biopsy tissue,and the different of two groups is significance(P<0.001).Furthermore,there was correlation between the positive rate of PLA2R1 and patients’pathological types,rather than patients’gender,age,or clinical stages in frozen or paraffin-embedded renal biopsy tissue.In addition,positive of PLA2R1 was richen in patients with idiopathic membranous nephropathy(IMN),and positive rate was 72.0%and 79.8%in each of frozen or paraffin-embedded renal biopsy tissue,while the positive rate of PLA2R1 in non-IMN was 3.0%and 19.4%.Conclusion The positive rate of PLA2R1 in renal biopsy tissue might be involved in the IMN,and frozen biopsy tissue might be better to using to aid the differential diagnosis of in nephropathy than paraffin-embedded biopsy tissue.