菌物学报2025，Vol.44Issue(12)：120-127,8.DOI:10.13346/j.mycosystema.250266
组织病理检查在真菌感染诊断中的临床应用价值
Clinical application value of histopathology in the diagnosis of fungal infections
摘要
Abstract
Early diagnosis of fungal infections is challenging.Histopathology is the gold standard for diagnosing invasive fungal diseases.To explore the value of histopathological examination in the clinical diagnosis on fungal infections,this study retrospectively analyzed 68 cases of fungal infection diagnosed by histopathology from two tertiary hospitals in Suzhou between 2015 and 2025.The analysis focused on the consistency between clinical expected diagnoses and histopathological diagnosis,description of fungi detected in histopathological terms,as well as origins of specimens and specimen types.In addition,HE staining and special fungal staining(PAS,GMS)were performed on stomach,lung and skin tissues to compare the differences in the identification of fungi by these staining methods.The results showed that only 8.8%cases were clinically expected fungal infection.Suspected fungal infection reported by histopathological detection accounted for 11.8%(8/68);fungal infection accounted for 88.2%cases(60/68);fungi identified at genus level accounted for 23.5%(16/68),including Aspergillus infection in 12 specimens from otolaryngology and 2 specimens from lung,Cryptococcus in one specimen from lung,Malassezia in one skin specimen.According to preliminary statistics,64.7%specimens were sent from the otorhinolaryngology,and secondarily from general surgery(14.7%,10/68).The highest rate of fungal detection were appeared in otorhinolaryngology and respiratory tract specimens.Among otorhinolaryngology specimens,89.7%(35/39)specimens were clinically undertermined as fungal infection,while none of the 10 cases from lung were determined clinically as fungal infection.All specimens are stained by hematoxylin-eosin(HE),while only 4 specimens are specially stained by periodic acid-Schiff(PAS),accounting for 5.9%(4/68).This study compared three staining methods and demonstrated that fungal specimens could be stained red or brown by PAS and GMS,making them easier to identify and reducing the risk of missed diagnosis.It is suggested that clinicians attach importance to histopathological examination in the diagnosis of fungal infections,in order to improve the diagnosis and treatment level.关键词
组织病理学/真菌诊断/病理特殊染色Key words
histopathology/the diagnosis of fungal/special staining in pathology引用本文复制引用
SHI Pancheng,XU Jinping,WANG Lu,SU Ling,DENG Shuwen,ZHANG Lu..组织病理检查在真菌感染诊断中的临床应用价值[J].菌物学报,2025,44(12):120-127,8.基金项目
苏州市科技计划(SKY2022037) （SKY2022037）
苏州市科技局科技发展计划-指导性项目(SYWD2024233,SYWD2025184) （SYWD2024233,SYWD2025184）
苏州高新区人民医院科学创新基金(SGY2021C01,SGY2022A01,SGY2022H01,SGY2025H01,SGY2023E01) （SGY2021C01,SGY2022A01,SGY2022H01,SGY2025H01,SGY2023E01）
江苏省高端医疗器械技术创新中心项目(BM2022012)This work was supported by the Suzhou Science and Technology Plan(SKY2022037),the Science and Technology Development Plan of Suzhou Science and Technology Bureau(SYWD2024233,SYWD2025184),the Science Innovation Fund of People's Hospital of SND(SGY2021C01,SGY2022A01,SGY2022H01,SGY2025H01,SGY2023E01),and the Project of Jiangsu High-end Medical Device Technology Innovation Center(BM2022012). （BM2022012）
