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本文引用的文献

1
Normal human skin is superior to monkey oesophagus substrate for detection of circulating BP180-NC16A-specific IgG antibodies in bullous pemphigoid.正常人体皮肤优于猴食道底物，用于检测大疱性类天疱疮患者循环 BP180-NC16A 特异性 IgG 抗体。
Br J Dermatol. 2019 May;180(5):1099-1106. doi: 10.1111/bjd.17313. Epub 2019 Jan 1.
2
Diagnostic value of autoantibody titres in patients with bullous pemphigoid.大疱性类天疱疮患者自身抗体滴度的诊断价值
Eur J Dermatol. 2018 Feb 1;28(1):3-12. doi: 10.1684/ejd.2017.3166.
3
BP180 Is Critical in the Autoimmunity of Bullous Pemphigoid.BP180在大疱性类天疱疮的自身免疫中起关键作用。
Front Immunol. 2017 Dec 8;8:1752. doi: 10.3389/fimmu.2017.01752. eCollection 2017.
4
Localized bullous pemphigoid in a melanoma patient with dual exposure to PD-1 checkpoint inhibition and radiation therapy.一名黑色素瘤患者在同时接受PD-1检查点抑制剂和放射治疗后出现局限性大疱性类天疱疮。
JAAD Case Rep. 2017 Aug 30;3(5):404-406. doi: 10.1016/j.jdcr.2017.06.004. eCollection 2017 Sep.
5
Bullous Pemphigoid: Use of C4d Immunofluorescent Staining in a Case With Repeated Negative Conventional Direct Immunofluorescence Studies.大疱性类天疱疮：C4d免疫荧光染色在常规直接免疫荧光研究反复阴性病例中的应用
Am J Dermatopathol. 2017 Dec;39(12):932-934. doi: 10.1097/DAD.0000000000000943.
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Bullous Pemphigoid: A Review of its Diagnosis, Associations and Treatment.大疱性类天疱疮：诊断、相关因素及治疗综述
Am J Clin Dermatol. 2017 Aug;18(4):513-528. doi: 10.1007/s40257-017-0264-2.
7
Questioning the specificity and sensitivity of ELISA for bullous pemphigoid diagnosis.质疑酶联免疫吸附测定法（ELISA）在大疱性类天疱疮诊断中的特异性和敏感性。
Cutis. 2017 Jan;99(1):E27-E30.
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Can immunohistochemistry replace immunofluorescence in diagnosis of skin bullous diseases?免疫组织化学能否替代免疫荧光用于诊断皮肤大疱性疾病？
APMIS. 2017 Feb;125(2):114-121. doi: 10.1111/apm.12643. Epub 2017 Jan 3.
9
Prospective studies on the routine use of a novel multivariant enzyme-linked immunosorbent assay for the diagnosis of autoimmune bullous diseases.前瞻性研究新型多变量酶联免疫吸附试验在自身免疫性大疱性疾病诊断中的常规应用。
J Am Acad Dermatol. 2017 May;76(5):889-894.e5. doi: 10.1016/j.jaad.2016.11.002. Epub 2016 Dec 28.
10
Diagnostic value of immunohistochemistry on formalin-fixed, paraffin-embedded skin biopsy specimens for bullous pemphigoid.免疫组织化学在福尔马林固定、石蜡包埋皮肤活检标本中对大疱性类天疱疮的诊断价值。
Br J Dermatol. 2016 Nov;175(5):988-993. doi: 10.1111/bjd.14686. Epub 2016 Aug 30.

用于大疱性类天疱疮诊断的C3d免疫组织化学染色与酶联免疫吸附测定及免疫荧光法的比较

Comparison of C3d immunohistochemical staining to enzyme-linked immunosorbent assay and immunofluorescence for diagnosis of bullous pemphigoid.

作者信息

Wang Leo L, Moshiri Ata S, Novoa Roberto, Simpson Cory L, Takeshita Junko, Payne Aimee S, Chu Emily Y

机构信息

Department of Dermatology, the University of Pennsylvania, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Division of Dermatology, University of Washington, Seattle, Washington.

出版信息

J Am Acad Dermatol. 2020 Jul;83(1):172-178. doi: 10.1016/j.jaad.2020.02.020. Epub 2020 Feb 14.

DOI:10.1016/j.jaad.2020.02.020
PMID:32068042
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7480887/
Abstract

BACKGROUND

Bullous pemphigoid (BP), the most common autoimmune blistering disease, may be diagnostically challenging. Direct immunofluorescence (DIF), indirect immunofluorescence (IIF), enzyme-linked immunosorbent assay (ELISA), and recently, C3d immunohistochemistry (IHC), are used as adjuncts to diagnosis.

OBJECTIVE

To compare C3d IHC to DIF, IIF, and ELISA testing in BP diagnosis.

METHODS

C3d IHC was performed on skin biopsy specimens from 51 patients (27 with BP and 24 with other blistering diseases) and compared to DIF and IIF, with anti-BP180 or anti-BP230 ELISA results used as the gold standard.

RESULTS

We found C3d IHC, DIF, and IIF had similar sensitivity (74.1%, 63.1%, and 70.4%), specificity (95.8%, 100%, and 100%), positive predictive value (95.2%, 100%, and 100%), and negative predictive value (76.7%, 70.6%, and 75%) for BP. Cases with positive C3d IHC, DIF, and IIF had significantly higher anti-BP180 and anti-BP230 by ELISA than cases with negative testing (P < .0001). False-negative IIF results were associated with lower BP230 compared with true-positive results (P = .03).

LIMITATIONS

This was a single-center, retrospective study.

CONCLUSION

Our study compared C3d IHC to DIF and IIF in BP diagnosis, demonstrating C3d IHC on fixed tissue provides similar diagnostic utility to immunofluorescence and ELISA.

摘要

背景

大疱性类天疱疮（BP）是最常见的自身免疫性水疱病，诊断可能具有挑战性。直接免疫荧光（DIF）、间接免疫荧光（IIF）、酶联免疫吸附测定（ELISA）以及最近的C3d免疫组织化学（IHC）被用作诊断的辅助手段。

目的

比较C3d免疫组织化学与DIF、IIF和ELISA检测在BP诊断中的作用。

方法

对51例患者（27例BP患者和24例其他水疱病患者）的皮肤活检标本进行C3d免疫组织化学检测，并与DIF和IIF进行比较，以抗BP180或抗BP230 ELISA结果作为金标准。

结果

我们发现C3d免疫组织化学、DIF和IIF对BP的敏感性（分别为74.1%、63.1%和70.4%）、特异性（分别为95.8%、100%和100%）、阳性预测值（分别为95.2%、100%和100%）和阴性预测值（分别为76.7%、70.6%和75%）相似。C3d免疫组织化学、DIF和IIF检测阳性的病例，ELISA检测的抗BP180和抗BP230水平显著高于检测阴性的病例（P <.0001）。与真阳性结果相比，IIF假阴性结果与较低的BP230相关（P = 0.03）。

局限性

这是一项单中心回顾性研究。

结论

我们的研究比较了C3d免疫组织化学与DIF和IIF在BP诊断中的作用，表明固定组织上的C3d免疫组织化学与免疫荧光和ELISA具有相似的诊断效用。