肾活检病理诊断报告模式专家共识.pdf

810 Chinese Journal of Practical Internal Medicine September 2017 Vol. 37 No. 9 指南与共识 DOI：10.19538/jnk2017090107 肾活检病理诊断报告模式专家共识 国家肾脏疾病临床医学研究中心，南京总医院 摘要：肾活检病理检查对于肾脏疾病的临床诊断、指导治疗、预后判断意义重大，而目前国内对肾活检病理诊断的整 套流程尚缺乏统一规范。本专家共识的目的在于制定我国肾活检病理检查的操作规范，从肾活检取材、病理染色、 病理检查观察项目等各方面，分别提出光镜、免疫荧光、电镜三种检查的描述规范，并最终整合为肾活检病理诊断报 告模板，以供国内同行参考借鉴。 关键词：肾活检 ；病理报告 中图分类号：R692.5　文献标识码：A Pathological diagnosis reporting consensus on kidney biopsy in China. National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210000, China Corresponding author: LIU Zhi-hong, E-mail: zhliunj@ Abstract: Renal biopsy is useful for diagnosis, therapy guidance and prognostic assessment of various kidney diseases. However, there is currently no consensus on the renal biopsy practice and the interpretation of renal biopsies in China. In this document we aim to provide the technical and interpretive skills required for the assessment of renal biopsies. We standardize the renal biopsy procedures, including renal tissue sampling, fixing, sectioning and staining, and the pathological evaluation of renal biopsies, including descriptions of light microscopy, immunofluorescence, and electron microscopy examination. The information in this article will serve as a practical guide to renal biopsy diagnosis in China. Keywords: renal biopsy; pathological report 肾活检病理检查不仅对肾脏疾病的诊断至关重 家共识。 要，还能提供指导临床治疗、判断疾病预后和揭示肾 1  肾活检取材和病理染色 脏疾病发病机制的重要信息。完整的肾活检病理检 查应该包含光镜、免疫病理及电镜检查三部分，从不 1.1  肾活检取材  经皮肾活检穿刺技术常采用切 同角度反映肾脏病变特点。良好的取材和特殊染色， 割式和抽吸式两种方法。穿刺针以16G为主，也可 标准规范的肾活检病理描述，基于病因和发病机制 选择18G或14G，尽量避免使用内径过细的穿刺针， 的病理报告模式，对于规范临床实践，获取标准化的 否则可能导致制片及诊断困难。肾活检要求取至 临床和病理数据至