David Lang, Walter Stoiber, Sylvia Lohfink-Schumm, Astrid Obermayer, Guangyu Shao, Bernhard Kaiser, Rupert Langer, Bernd Lamprecht
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引用次数: 0
摘要
我们评估了透射电子显微镜(TEM)在经支气管肺冷冻活检(TBLC)样本中的应用,这些样本来自16名接受纤维化间质性肺病(ILD)常规评估的连续患者。除常规病理检查外,还准备了 1 到 2 份 TBLC 样品用于 TEM 分析,并使用蔡司 LEO EM 910 进行评估。非 ILD 肺癌患者的胸膜下冷冻活检组织和新鲜肺叶切除组织的解冻切除活检组织作为对照。与对照组相比,TEM 可提供高质量的图像,仅有轻微的低温伪影。此外,在几名 ILD 患者身上,我们发现了明显的微血管内皮异常,如管腔伪足样突起和内表面缺损。这些异常在四名患者(25%)中广泛存在,在七名患者(43.8%)中中度存在,在五名患者(31.3%)中基本不存在。TEM 内皮异常程度较高与年龄较小、非特异性间质性肺炎模式、支气管肺泡灌洗液淋巴细胞计数较高、自身抗体阳性以及肺活量、扩散能力和氧合生物标志物较低有关。我们的结论是,对 ILD 患者的 TBLC 样本进行 TEM 评估是可行的,而观察到的微血管改变值得进一步评估。
Transmission electron microscopy of transbronchial lung cryobiopsy samples in a cohort of fibrotic interstitial lung disease patients - feasibility and implications of endothelial alterations.
We evaluated the utility of transmission electron microscopy (TEM) in transbronchial lung cryobiopsy (TBLC) samples from 16 consecutive patients undergoing routine evaluation of fibrotic interstitial lung disease (ILD). Next to routine pathology examination, 1 to 2 TBLC samples were prepared for TEM analysis and evaluated using a Zeiss LEO EM 910. Subpleural cryobiopsies and unfrozen excision biopsies from fresh lobectomy tissue of non-ILD lung cancer patients served as controls. TEM provided high-quality images with only minor cryoartifacts as compared to controls. Furthermore, in several ILD patients we found marked microvascular endothelial abnormalities like luminal pseudopodia-like protrusions and inner surface defects. These were extensively present in four (25%), moderately present in seven (43.8%), and largely absent in five (31.3%) patients. A higher degree of TEM endothelial abnormalities was associated with younger age, non-specific interstitial pneumonia pattern, higher broncho-alveolar lavage lymphocyte count, positive autoantibodies, and lower spirometry, diffusion capacity and oxygenation biomarkers. We conclude that TEM evaluation of TBLC samples from ILD patients is feasible, while the observed microvascular alterations warrant further evaluation.
期刊介绍:
Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases.
As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion.
Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.