Amyloidosis is the result of various, differently approachable diseases. It is vital to subtype the amyloid deposits in order to establish and finally treat the underlying disease properly. Besides the classical staining with Congo red, further procedures like immunohistochemical staining are needed for classification. Here, we present a more accurate approach using Congo red/immunohistochemical double staining easily applicable in routine diagnostics. Modifications of the Congo red staining technique and the immunohistochemical procedures were needed in order to combine both staining procedures on one slide. The evaluation was done using conventional light and fluorescence microscopy. By shortening the staining time for Congo red to 10 s and by modification regarding endogenous peroxidase blockage, accurate results could be obtained for evaluating the Congo red/immunohistochemistry double staining using a fluorescence microscope. Sections of 2 μm instead of 4 μm thickness were superior for evaluation, since they increased staining specificity. The combination of Congo red and immunohistochemistry as in situ double staining on one slide is a feasible approach in the diagnosis of amyloidosis. It allows focusing on the fluorescent Congo red-positive areas when evaluating immunohistochemistry, thus avoiding signing out false-positive results. Additionally, it increases the signal-to-noise ratio of the immunohistochemically stained sections on conventional microscopy.

译文

淀粉样变性是各种不同的易接近的疾病的结果。为了建立并最终正确治疗潜在疾病,对淀粉样蛋白沉积物进行亚型分型至关重要。除了用刚果红进行经典染色外,还需要进一步的程序 (如免疫组织化学染色) 进行分类。在这里,我们提出了一种使用刚果红/免疫组织化学双重染色的更准确的方法,该方法易于用于常规诊断。为了在一张载玻片上结合两种染色程序,需要修改刚果红染色技术和免疫组织化学程序。使用常规的光学和荧光显微镜进行评估。通过将刚果红的染色时间缩短至10 s,并通过对内源性过氧化物酶阻断进行修饰,可以获得使用荧光显微镜评估刚果红/免疫组织化学双重染色的准确结果。2μm而不是4μm厚度的切片更适合评估,因为它们增加了染色特异性。刚果红和免疫组织化学结合在一张玻片上进行原位双重染色是诊断淀粉样变性的可行方法。在评估免疫组织化学时,可以将重点放在荧光刚果红阳性区域,从而避免签出假阳性结果。此外,它增加了常规显微镜下免疫组织化学染色切片的信噪比。

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