直接免疫荧光检查诊断口腔黏膜大疱类疾病临床价值研究

The significance of direct immunofluorescence test in the diagnosis of oral mucosal bullous diseases

目的探讨直接免疫荧光(direct immunofluorescence,DIF)检查在口腔黏膜大疱类疾病诊断中的价值。方法回顾性分析2009年5月至2014年3月中国医科大学口腔医学院确诊的73例口腔黏膜大疱类疾病患者的DIF检查结果,总结各类型口腔黏膜大疱类疾病的DIF表现特点,并与组织病理检查对该类疾病诊断的敏感性进行比较。结果 (1)各类型口腔黏膜大疱类疾病的DIF表现各具特征性,其中天疱疮可见表皮细胞间Ig G和(或)C3呈弥漫网状沉积,偶有Ig M、Ig A及纤维蛋白原沉积;类天疱疮可见基底膜带C3和(或)Ig G呈线状沉积,少有Ig M、Ig A及纤维蛋白原沉积。(2)DIF检查诊断口腔黏膜大疱类疾病的敏感性为76.7%,与组织病理检查敏感性(75.3%)相比,差异无统计学意义(χ2=0.038,P>0.05)。结论 DIF检查是诊断口腔黏膜大疱类疾病的重要手段,特别是当临床与组织病理诊断困难时,DIF技术极有价值。

Objective To investigate the clinical significance of direct immunofluorescence test in the diagnosis of oral mucosal bullous diseases.MethodsThe DIF features were reviewed in 73 oral mucosa bullous disease patients who were admitted to Affiliated Stomatological Hospital of China Medical University from May 2009 to March 2014. The diagnostic sensitivity of DIF was compared with that of histopathologic examination.ResultsPemphigus and pemphigoid showed different DIF features. The diagnostic sensitivity of DIF was 76.7%,which showed no significant difference from that of histopathologic findings（75.3%）（P〉0.05）.ConclusionDIF plays a significant role in the diagnosis of oral mucosal bullous diseases,especially when clinical and histopathological diagnosis is difficult to get the right results.