中国麻风皮肤病杂志 ›› 2019, Vol. 35 ›› Issue (3): 129-132.doi: 10.12144/zgmfskin201903129

• 论著 •    下一篇

反射式共聚焦显微镜诊断扁平苔藓的敏感性与特异性分析

孟庆雯1,2  陈声利3  卢宪梅3  周桂芝3  林燕3  周燕3  夏杨3  刘华绪1,3   

  1. 1济南大学 山东省医学科学院医学与生命科学学院，山东济南，250000
    2济宁市皮肤病防治院，山东济宁， 272001
    3山东省皮肤病性病防治研究所，山东省皮肤病医院，山东济南， 250022
  • 出版日期:2019-03-15 发布日期:2019-04-03
  • 通讯作者: 刘华绪，E-mail: liueternal@163.com

Sensitivity and specificity analysis of the reflection confocal microscopy in the diagnosis of lichen planus

MENG Qingwen1,2，CHEN Shengli3,LU Xianmei3, ZHOU Guizhi3, LIN Yan3,ZHOU Yan3,XIA Yang3,LIU Huaxu1,3   

  1. 1. School of Medicine and Life Sciences，University of Jinan－Shandong Academy of Medical Sciences，Jinan 250000，China; 2. Jining Institute of Dermatology, Jining 272001, China; 
    3. Shandong Provincial Institute of Dermatology and Venereology，Shandong Provincial Hospital for Skin Diseases，Jinan 250022，China
  • Online:2019-03-15 Published:2019-04-03
  • Contact: LIU Huaxu，E-mail: liueternal@163.com

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摘要： 目的：分析反射式共聚焦显微镜(RCM)下扁平苔藓(LP)图像特征诊断的敏感性与特异性。方法：对我院就诊的临床初步拟诊为扁平苔藓的患者进行RCM检查，然后于相同皮损处行组织病理学检查，对照组织病理学表现分析其RCM图像特征，提炼图像共性特征，分析这些图像特征诊断的敏感性和特异性。结果：共入组78例患者，扁平苔藓的RCM图像特征为：较之周围正常皮肤，皮损区域（1）表皮角质层颗粒层不规则增厚；（2）伴表皮突向下延伸的棘层不规则增厚；（3）基底细胞液化变性；（4）真皮浅层淋巴细胞、组织细胞带状浸润。其中基底细胞液化变性敏感性最高为97.87％，特异性为58.06％；同时存在两种指标（2）和（4）这一组特异性最高为93.55%。结论：LP的RCM图像特征明确，诊断的敏感性与特异性均较高，可应用于LP的常规筛查。

关键词: RCM, 扁平苔藓, 特异性与敏感性

Abstract: Objective: To investigate the diagnostic sensitivity and specificity of image features of lichen planus by Reflective Confocal Microscope (RCM). Methods: RCM was performed on patients suspicious of lichen planus in our hospital, and then histopathological examination were done on the same lesion. The characteristics of RCM images were correlated with histopathological results. The common features of images were extracted, and then the sensitivity and specificity of diagnosis of these image features were analyzed. Results: A total of 78 patients were enrolled in the study group. The image features of RCM in lichen planus were as follows: (1) irregular thickening of stratum corneum and granular layer ; (2) irregular thickening of spinous layer with downward extension of epidermal rete ridges; (3) liquefaction degeneration of basal cells; (4) banded infiltration of lymphocytes and histiocytes in superficial dermis layer. The sensitivity and specificity of basal cell liquefaction degeneration were 97.87% and 58.06%, respectively. The specificity of the group with（2）+（4） was 93.55%. Conclusion: The RCM images of LP correlated very well with histology analysis and the high sensitivity and specificity of RCM features of LP could be used for routine screening of LP.

Key words: RCM, lichen planus, specificity and sensitivity