Influence of fixation and immunohistological technique on accuracy, precision and inter-observer reproducibility of plasma cell counting. |
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Authors: | C Bodeutsch P C de Wilde J C van Houwelingen G P Ebben H M Kerstens L Kater L B van de Putte G P Vooijs |
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Affiliation: | Department of Pathology, University Hospital, Nijmegen, The Netherlands. |
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Abstract: | Recently two highly sensitive and specific diagnostic criteria for Sj?gren's syndrome based on percentages of IgA-, IgG-, and IgM-containing plasma cells measured in immunohistologically stained labial salivary gland tissue have been described. The reliability of such a criterion is dependent on the accuracy, precision and inter-observer reproducibility in plasma cell counting. The present study evaluates the effect of tissue fixation and immunohistological procedures on the aforementioned factors. Immunoglobulin (Ig)-containing plasma cells in sections of lamellated submandibular salivary gland tissue, alternately fixed in a 4% buffered formol solution or formol-sublimate solution and stained with an indirect immunoperoxidase and unlabelled peroxidase anti-peroxidase (PAP) method respectively, were enumerated by three independent observers. Relative numbers of Ig-containing plasma cells appeared to be less sensitive for systematic errors due to tissue fixation and immunohistological procedure than absolute numbers of Ig-containing plasma cells. The best inter-observer reproducibility of plasma cell counts was obtained in sections from formol sublimate-fixed specimens stained according to the PAP procedure. |
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