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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 value of direct immunofluorescence (DIF) in the diagnosis of oral mucosal bullous diseases. Methods The results of DIF examination of 73 cases of oral mucosal bullous diseases confirmed by Stomatology School of China Medical University from May 2009 to March 2014 were retrospectively analyzed. The DIF findings of various types of oral mucosal bullous diseases were summarized and analyzed. And histopathological examination of the sensitivity of these diseases were compared. Results (1) The DIF manifestations of various types of oral mucosal bullous diseases have their own characteristics. Among them, pemphigus IgC and / or C3 showed diffuse reticular deposition in epidermal cells, occasionally Ig M, Ig A and fibers Proteoglycan deposition; pemphigus visible basement membrane C3 and (or) Ig G was linear deposition, less Ig M, Ig A and fibrinogen deposition. (2) The sensitivity of DIF examination for the diagnosis of oral mucosal bullous diseases was 76.7%, which was not significantly different from the histopathological examination (75.3%) (χ2 = 0.038, P> 0.05). Conclusion DIF examination is an important method for the diagnosis of oral mucosal bullous diseases. Especially when clinical and histopathological diagnosis is difficult, DIF is of great value.