中国实用口腔科杂志

中国实用口腔科杂志 ›› 2021, Vol. 14 ›› Issue (4): 447-451.DOI: 10.19538/j.kq.2021.04.012

• 论著 • 上一篇    下一篇

基于2003年改良WHO诊断标准的口腔扁平苔藓临床病理分析

  

  1. 北京大学口腔医学院·口腔医院a黏膜科，b口腔病理研究室；国家口腔医学中心；国家口腔疾病临床医学研究中心；口腔数字化医疗技术和材料国家工程实验室；北京  100081
  • 出版日期:2021-07-30 发布日期:2021-07-30
  • 通讯作者: 华红
  • 基金资助:
    国家自然科学基金（81730030）

  • Online:2021-07-30 Published:2021-07-30

摘要： 目的    基于2003年改良世界卫生组织（World Health Organization，WHO）诊断标准，评估口腔扁平苔藓的临床病理诊断符合率，并分析其可能的影响因素，为提升临床精准诊断提供科学依据。方法    基于2003年改良WHO诊断标准，回顾北京大学口腔医院黏膜科2020年1—12月临床诊断为口腔扁平苔藓患者的病理诊断情况，每张病理切片至少由2名病理医生给出病理报告。并收集患者临床资料，分析其与临床病理诊断符合率的相关性。结果    口腔扁平苔藓的临床病理诊断符合率为74%，活检部位的选择、活检部位有无充血、病程长短和临床类型与口腔扁平苔藓的临床病理诊断符合率相关（均P < 0.05）。logistic回归分析发现，活检部位为牙龈（OR = 9.735，95%CI：1.797 ~ 52.726，P = 0.008）或舌腹（OR = 3.214，95%CI：1.404 ~ 7.360，P = 0.006）、病程> 1年（OR = 2.913，95%CI：1.597 ~ 5.316，P < 0.001）为影响口腔扁平苔藓临床病理诊断符合率的独立因素。结论    口腔扁平苔藓的临床表现多样，病理诊断是明确诊断及病情监测的重要依据。活检部位选择牙龈、舌腹或病程长于1年会影响临床病理诊断符合率。

关键词: 口腔扁平苔藓, 病理诊断, 相关影响因素

Abstract: Objective    To assess the correlation between the clinical and histopathologic diagnoses of oral lichen planus（OLP）based on the modified World Health Organization（WHO）diagnostic criteria revised in 2003 and analyze the possible factors. Methods    The patients with OLP diagnosed clinically from January 2020 to December 2020 in the Department of Oral Medicine，Peking University Hospital of Stomatology，were conducted routine biopsy and each HE slide was reviewed by 2 pathologists individually. The correlation with the clinical-pathological diagnosis concordance rate of OLP was analyzied and clinical data of these patients were also collected. Results    The clinical pathological concordance rate in present study was 74%. The clinical-pathological concordance rate was influenced by different biopsy site，biopsy site with or without congestion and the course of OLP（P < 0.05）. Logistic regression analysis showed that gingiva（OR = 9.735，95%CI：1.797 - 52.726，P = 0.008），or the ventrum of the tongue（OR = 3.214，95%CI：1.404 - 7.360，P = 0.006），and the course of OLP >1 year（OR = 2.913，95%CI：1.597 - 5.316，P < 0.001）were independent factors of the concordance rate with the clinical-pathological diagnosis of OLP. Conclusion    OLP has a variety of clinical manifestations，and pathological diagnosis is an important basis for clinical accurate diagnosis and follow-up treatment. The selection of biopsy site，especially gingiva or lingual ventrum，and the duration of disease longer than 1 year will affect the concordance rate with the clinical-pathological diagnosis of OLP. 

Key words: oral lichen planus, histopathologic diagnoses, related influencing factors