消化管生検材料の迅速パラフィン切片標本作成について―2時間法の検討

An Improved Method of Treament of Gastric Biopsy Specimens: 2-hour paraffin peparation

　近年消化器疾患においてグラスファイバーを使用した内視鏡が発達するにつれて生検材料採取の機会が増加し，内視鏡診断の中で生検所見の占める位置は大きく，肉眼的に疑わしい例では生検による確定診断は不可欠となっているのであるが，正しい病理診断を得るためには良い組織標本を作成することが必須の条件であって，また日常診療上の必要性から可及的速かに材料の処理が行なわれることは医師および患者の両面より望まれることである．

　この迅速性という目的のために従来より凍結切片法が行なわれて来たが，組織保存性および染色性の点で制約があり，時に所見を正確に把握し難い標本に遭遇する場合もある．これに反して一般に行なわれている10％ホルマリンに始まるパラフィン包埋切片は作成に数日を要するのが通常で，その作成の過程で最近種々の自動化が試みられているが時間的な制約の改善は望めないのが現状である．

　Recent development of glass fiber endoscopy has enabled us to perform biopsy in almost the entire area of the upper gastrointestinal tract. In order to facilitate biopsy diagnosis, we attempted the present investigations to shorten the time necessary for obtaining a usual paraffin preparation.

　Small pieces of tissue 2mm. in diameter taken from the resected stomach by punching with a gastric biopsy clamp were placed on a filter paper. These specimens were treated in various ways with formalin fixation, dehydration with 70, 85, and 100 per cent ethanol, chloroform and paraffin immersion, and some staining procedures.

　It was revealed that the whole procedures for obtaining a usual paraffin preparation could be completed within a total of 2 hours; the procedures are as follows: 20 per cent formalin for 5 min., 70 per cent ethanol 20 min., 85 per cent 10 min., 100 per cent 5 min., chloroform 3 min., paraffin at 58℃ 15 min., and usual hematoxylin-eosin stain, including microtome sectioning, for one hour.

　The advantages of the improved paraffin preparation are that modes of tissue preservation and staining surpass those of the conventional frozen-section prepation, microscopic specimens are available within 2 hours, and that when other stains are required for further analysis additional sectioning of the specimen can easily be made from the residual paraffin block. It is believed that this method will make biopsy diagnosis of upper gastrointestinal diseases more attainaible as a routine of an out-patient clinic, as has long been desired by both doctors and patients.