反射式共聚焦显微镜诊断扁平苔藓的敏感性与特异性研究

Sensitivity and specificity of reflective confocal microscopy in diagnosis of lichen planus

目的探讨反射式共聚焦显微镜(RCM)诊断扁平苔藓的敏感性与特异性。方法择取2018年6月至2019年6月来中国人民解放军联勤保障部队第九九〇医院例就诊的拟诊为扁平苔藓的患者作为研究对象,患者入院后均采用RCM及组织病理学活检术检查,观察扁平苔藓类型,将RCM结果与组织病理学活检术结果作对比,计算反射式共聚焦显微镜的诊断符合率、敏感性、特异性及准确性。结果经病理检查后确诊为扁平苔藓患者32例,反射式共聚焦显微镜共诊出30例,漏诊2例,其中1例环形扁平苔藓,1例急性泛发性扁平苔藓,其诊断符合率为93.75%;经计算反射式共聚焦显微镜的敏感性为93.75%,特异性为100%、准确性为96.00%。结论反射式共聚焦显微镜诊断扁平苔藓的敏感性、特异性与准确性较高,可用于扁平苔藓患者的临床诊断,但其具有局限性,尚有一定的发展空间。

【Objective】To investigate the sensitivity and specificity of reflective confocal microscopy(RCM)in the diagnosis of lichen planus.【Methods】From June 2018 to June 2019,50 patients with tinea capitis were selected as subjects.RCM and histopathological biopsy were performed after admission,the type of lichen planus was observed,and RCM results were compared with histopathological biopsy results.The diagnostic coincidence rate,sensitivity,specificity and accuracy of reflective confocal microscope were calculated.【Results】Thirty-two patients with tinea capitis were diagnosed by pathological examination.Thirty cases were diagnosed by reflective confocal microscopy,two cases were missed,there was one case of ring lichen planus,one case of acute generalized lichen planus,and the diagnostic coincidence rate was 93.75%.The sensitivity of the reflective confocal microscope was 93.75%,specificity was 100%and accuracy was 96.00%.【Conclusion】The sensitivity,specificity and accuracy of reflective confocal microscopy in the diagnosis of lichen planus are high,it can be used for clinical diagnosis of tinea capitis,but it has limitations,there is still room for its development.