摘要
目的 认识非阿尔茨海默型痴呆的组织学特征和组织类型以及免疫组织化学在诊断中的意义。方法 对 2 2例尸检确诊的神经变性痴呆脑组织进行了Bodian、Gallyas Braak染色 ,tau和泛素免疫组织化学染色 ,观察脑组织中神经元和胶质细胞包涵体的形态特征 ,分布和蛋白质表达活性。根据非阿尔茨海默型痴呆的组织学标准 ,结合临床进行病理诊断。结果 2 2例神经变性痴呆中 ,12例诊断为非阿尔茨海默型痴呆。其中皮克病 2例 ,进行性核上性麻痹和皮质基底节变性各 3例 ,皮质型路易小体痴呆 1例 ,帕金森病合并痴呆 3例。其余 10例中 ,9例诊断为单纯阿尔茨海默病 ,1例为阿尔茨海默病合并嗜银颗粒痴呆。在非阿尔茨海默型痴呆的脑组织观察到特征性神经元和胶质细胞包涵体 ,包括经典型和皮质型路易小体 ,皮克小体 ,球形团样神经原纤维缠结 ,星形细胞斑和葱状星形细胞 ,嗜银颗粒。除路易小体外 ,其他包涵体结构具有嗜银性 ;路易小体主要表达泛素 ,皮克小体可表达tau和泛素 ,而球形团样神经原纤维缠结、星形细胞斑、葱状星形细胞、嗜银颗粒仅对tau免疫染色敏感。结论 采用Gallyas Braak染色 ,tau和泛素免疫组织化学染色等新方法能够敏感地显示特征性神经元和胶质细胞包涵体 。
Objective To characterize histopathologic features of non-Alzheimer type dementia. Methods Bodian, Gallyas-Braak silver staining, tau and ubiquitin immunohistochemistry were applied in an analysis of 22 cases of autopsy-proven neurodegenerative dementia. Appearance, distribution and immunoreactivity of neuronal and glial inclusions in the brain were observed. The final histological diagnoses were made according to the pathological criteria for several types of common non-Alzheimer type dementia. Results Among the 22 cases of neurodegenerative dementia, 12 cases were identified as non-Alzheimer type dementia, including Pick′s disease (2 cases), progressive supranuclear palsy (3 cases) and corticobasal degeneration (3 cases), dementia with Lewy bodies (1 case), and Parkinson′s disease (3 cases). Another 10 cases consisted of pure Alzheimer′s disease (AD, 9 cases) and AD combined with argyrophilic grain disease (1 case). Characteristic neuronal and glial inclusions, such as classical and cortical Lewy body, Pick body, Globous NFTs, astrocytic plaque and tufted astrocyte, argyrophilic grain were found in the brains of non-Alzheimer type dementia. Classical and cortical Lewy bodies were not argyro- philic but were immunoreactive to ubiquitin. Pick bodies, Globous NFTs, astrocytic plaques, tufted astrocytes and argyrophilic grains were all argyrophilic. Pick bodies showed tau and ubiquitin immunoreactivity. However, Globous NFTs, astrocytic plaques, tufted astrocytes, and argyrophilic grains were reactive only to tau immunohistochemistry. Conclusions Findings of characteristic neuronal and glial inclusions may help to differentiate non-Alzheimer type dementia from AD, and in conjunction with Gallyas-Braak staining and immunohistochemistry for tau and ubiquitin, to further define histopathologic subcategories of non-Alzheimer type dementia.
出处
《中华病理学杂志》
CAS
CSCD
北大核心
2004年第5期408-412,共5页
Chinese Journal of Pathology
基金
军队"十五"医药卫生科研重点资助项目 ( 0 1Z0 3 7)
