改良Masson染色法在慢性乙型肝炎及肝硬化病理學診斷中應用

周冬青

[摘要] 目的 研究一種改良的Masson染色方法用來顯示肝組織中膠原纖維，作為慢性乙型肝炎、肝硬化纖維化程度的病理分期標準，為臨床治療提供幫助。方法 方便選取2012年6月—2016年12月徐州市傳染病醫院病理室50例石蠟包埋肝組織切片，采用在傳統Masson染色基礎上進行改良的染色方法進行膠原纖維染色，根據染色結果顯示慢性乙型肝炎及肝硬化肝組織中膠原纖維增生情況，作為病理診斷纖維化程度依據，染色結果與傳統染色方法進行對比，并結合臨床資料，判斷病理診斷的分級、分期與臨床診斷的分度是否一致，來評價其應用價值。結果 根據患者HE染色結果和改良的Masson染色顯示的膠原纖維染色結果，進行慢性肝炎病理分級、分期診斷及肝硬化診斷，50例患者中慢性乙型肝炎輕度有6例（G1-2，S1-2），慢性乙型肝炎輕-中度（G2-3、，S2-3）及中度（G3、，S3）有36例，慢性乙型肝炎重度2例（G4S2），早期肝硬化2例（G3S4），肝硬化4例，結合患者臨床資料，根據染色結果作出的病理學診斷的分級、分期與患者的臨床分度基本一致，有2例患者臨床診斷為慢性乙型肝炎，經染色后病理診斷為肝硬化。結論 改良Masson染色法與傳統染色方法染色結果對比切片背景清晰，膠原纖維色澤鮮艷，對比度強，能夠顯示較細小的膠原纖維，染色效果更好，能滿足臨床病理學診斷的纖維化分期要求，具有重要的應用價值。

[關鍵詞]改良Masson染色法；慢性乙型肝炎；肝硬化；病理學診斷

[中圖分類號] R4 [文獻標識碼] A [文章編號] 1674-0742（2017）03（b）-0046-03

[Abstract] Objective To research a kind of modified Masson staining method used to show the collagen fibrils in liver tissue and provide help for the clinical treatment by using it as the pathological staging standards of chronic hepatitis B and liver cirrhosis fibrosis degree. Methods 50 cases of paraffin embedding hepatic tissue slices in the pathological room in our hospital from June 2012 to December 2016 were selected and dyed by collagen fibrils on the basis of the traditional Masson staining method， and the collagenous fiber hyperplasia in the chronic hepatitis B and liver cirrhosis liver tissues were showed according to the staining results， as the basis of diagnosis of fibrosis degree， and the staining method and the traditional staining method was compared and whether the pathological diagnosis grading and staging was consistent with the clinical diagnosis division were determined according to the clinical data and its application value was evaluated. Results The HE staining results and modified Masson staining results showed that in the 50 cases of patients， there were 6 cases with mild chronic hepatitis B（G1-2，S1-2）， 36 cases with mild-moderate chronic hepatitis B （G2-3，，S2-3）- （G3，，S3）， 2 cases with severe chronic hepatitis B （G4S2）， 2 cases with early liver cirrhosis（G3S4） and 4 cases with cirrhosis and the pathological diagnosis grading and staging according to the staining results was basically consistent with the clinical grading， and 2 cases were diagnosed with chronic hepatitis B and diagnosed with liver cirrhosis after dyeing. Conclusion Compared with the traditional staining method， the slice background of modified Masson staining method is clear， the color of collagen fibrils is bright， and the contrast is strong， which can show the tiny collagen fibers， and the staining effect is better， and it can meet the clinical pathological diagnosis fibrillation staging requirements with important application value.

[Key words] Modified Masson staining method； Chronic hepatitis B； Liver cirrhosis； Pathological diagnosis

慢性乙型肝炎是由乙型肝炎病毒（HBV）感染肝細胞后激發免疫反應引起的慢性炎癥，全球約3.5億人曾感染過HBV，我國每年約30萬人死于與HBV相關的肝臟疾病所致的肝硬化、肝癌等嚴重肝病[1]。……