Identification of central nervous system injury is a critical part of perinatal autopsies; however, injury is not always easily identifiable due to autolysis and immaturity of the developing brain. Here, the role of immunohistochemical stains in the identification of perinatal brain injury was investigated. Blinded semiquantitative scoring of injury was performed on sections of frontal lobe from 76 cases (51 liveborn and 25 stillborn) using H&E, GFAP, Iba-1, and β-APP stains. Digital image analysis was used to quantify GFAP and Iba-1 staining. Commonly observed pathologies included diffuse white matter gliosis (DWMG) and white matter necrosis (WMN). DWMG scores were very similar on H&E and GFAP stains for liveborn subjects. For stillborn subjects, DWMG scores were significantly higher on GFAP stain than H&E. β-APP was needed for identification of WMN in 71.4% of stillborn subjects compared to 15.4% of liveborn subjects. Diffuse staining for Iba-1 within cortex and white matter was positively correlated with subject age. Staining quantification on digital image analysis was highly correlated to semiquantitative scoring. Overall, GFAP and β-APP stains were most helpful in identifying white matter injury not seen on H&E in stillborn subjects. Immunostains may therefore be warranted as an integral part of stillborn brain autopsies.

中文翻译：

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免疫组织化学染色在围产期脑尸检中的作用

中枢神经系统损伤的鉴定是围产期尸检的关键部分；然而，由于自溶和发育中的大脑不成熟，损伤并不总是容易识别。在此，研究了免疫组织化学染色在识别围产期脑损伤中的作用。使用 H&E、GFAP、Iba-1 和 β-APP 染色对 76 例（51 例活产和 25 例死产）的额叶切片进行盲法半定量损伤评分。使用数字图像分析来量化 GFAP 和 Iba-1 染色。常见的病理包括弥漫性白质神经胶质增生（DWMG）和白质坏死（WMN）。活产受试者的 H&E 和 GFAP 染色的 DWMG 评分非常相似。对于死产受试者，GFAP 染色的 DWMG 评分显着高于 H&E。71.4% 的死产受试者需要 β-APP 来识别 WMN，而活产受试者的这一比例为 15.4%。皮质和白质内 Iba-1 的弥漫染色与受试者年龄呈正相关。数字图像分析的染色定量与半定量评分高度相关。总体而言，GFAP 和 β-APP 染色对于识别死产受试者的 H&E 上未见的白质损伤最有帮助。因此，免疫染色可能是死产脑尸检的一个组成部分。