Zhou Tingting, Fang Siyue, Li Chunlei, Hua Hong
Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.
J Oral Pathol Med. 2016 Nov;45(10):786-790. doi: 10.1111/jop.12439. Epub 2016 Mar 23.
Pemphigus is one of the potentially fatal autoimmune blistering diseases. An early and accurate diagnosis is important for prognosis and therapy. It may be difficult to diagnosis based on clinical grounds alone. Direct and indirect immunofluorescence, enzyme-linked immunosorbent assay, the Tzanck smear test, or histopathology are all available for the diagnosis of pemphigus. However, there are no generally accepted diagnostic criteria for the diagnosis of this condition at present.
To evaluate the diagnostic value of indirect immunofluorescence, enzyme-linked immunosorbent assay, and the Tzanck smear test for the diagnosis of pemphigus in dental clinics.
A single-center retrospective study was conducted, and the clinical data of 33 patients with pemphigus and 61 controls were collected and analyzed from the Department of Oral Medicine, Peking University School of Stomatology, during 2010-2014. The sensitivities and specificities of indirect immunofluorescence, enzyme-linked immunosorbent assay, and the Tzanck smear test were calculated and compared in two groups.
Sensitivities for the Tzanck smear test, indirect immunofluorescence, and enzyme-linked immunosorbent assay were 96.7%, 84.8%, and 84.8%, respectively, whereas the specificities of these tests were 60%, 91.8%, and 96.7%, respectively. The serial tests for the Tzanck smear test and enzyme-linked immunosorbent assay showed 82% sensitivity and 98.7% specificity.
The serial test for the Tzanck smear test and enzyme-linked immunosorbent assay may represent a simple, rapid, and reliable way to definitive diagnosis of pemphigus. It is recommended as a common test for the diagnosis of pemphigus in dental clinics.
天疱疮是一种潜在致命的自身免疫性疱病。早期准确诊断对预后和治疗很重要。仅基于临床依据可能难以诊断。直接和间接免疫荧光、酶联免疫吸附测定、Tzanck涂片试验或组织病理学均可用于天疱疮的诊断。然而，目前尚无普遍接受的该疾病诊断标准。
评估间接免疫荧光、酶联免疫吸附测定和Tzanck涂片试验在牙科诊所诊断天疱疮的价值。
进行单中心回顾性研究，收集并分析了2010年至2014年期间北京大学口腔医学院口腔内科33例天疱疮患者和61例对照的临床资料。计算并比较两组中间接免疫荧光、酶联免疫吸附测定和Tzanck涂片试验的敏感性和特异性。
Tzanck涂片试验、间接免疫荧光和酶联免疫吸附测定的敏感性分别为96.7%、84.8%和84.8%，而这些试验的特异性分别为60%、91.8%和96.7%。Tzanck涂片试验和酶联免疫吸附测定的系列试验显示敏感性为82%，特异性为98.7%。
Tzanck涂片试验和酶联免疫吸附测定的系列试验可能是一种简单、快速且可靠的确诊天疱疮的方法。推荐作为牙科诊所诊断天疱疮的常用检查。
