基于生物芯片马赛克的间接免疫荧光法与口腔直接免疫荧光法在口腔黏膜类天疱疮患者中的比较
Comparison of BIOCHIP Mosaic Based Indirect Immunofluorescence and Oral Direct Immunofluorescence in Patients with Oral Mucosal Pemphigus.
作者信息
Muralitharan Amrithaa, Rai Reena, Shanmugasundaram Sakthisankari
机构信息
Department of Dermatology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
出版信息
Indian Dermatol Online J. 2024 Oct 4;15(6):982-985. doi: 10.4103/idoj.idoj_2_24. eCollection 2024 Nov-Dec.
BACKGROUND
Oral mucosal lesions in pemphigus vulgaris may precede cutaneous lesions and can cause diagnostic confusion. Diagnosis can be made by histopathology, direct immunofluorescence (DIF), and indirect immunofluorescence (IIF). DIF of the oral mucosa is an invasive procedure and difficult to perform in patients with severe mucosal ulcer, and studies have shown that BIOCHIP-IIF can be used to detect desmoglein 1 and 3 in the serum of patients with pemphigus.
AIM
To compare BIOCHIP mosaic-based IIF and oral DIF in patients with oral mucosal pemphigus.
MATERIALS AND METHODS
All cases of oral mucosal pemphigus which were diagnosed by clinical examination and histopathology were included in the study. Oral DIF and BIOCHIP-IIF samples were collected, and the results were analyzed.
RESULTS
Out of 36 patients, DIF was positive in 30 patients (83.3%) and BIOCHIP-IIF in 28 patients (77.8%). On comparing BIOCHIP-IIF with DIF, sensitivity, specificity, positive predictive value, and negative predictive value of BIOCHIP were 80%, 33.3%, 85.71%, and 25%, respectively. Chi-square test showed no statistically significant difference between oral DIF and BIOCHIP-IIF ( value is 0.5143). Among the 28 patients who had positive BIOCHIP, 27 patients (96.4%) showed desmoglein (Dsg) 3 positivity, and 16 patients (57.1%) showed Dsg 1 positivity. The sensitivity and specificity of Dsg1 were 53.3% and 100%, respectively. The sensitivity and specificity of Dsg3 were 76.6% and 33.3%, respectively.
CONCLUSION
BIOCHIP-IIF can be used as an alternative to oral DIF in the diagnosis of oral mucosal pemphigus.
背景
寻常型天疱疮的口腔黏膜损害可能先于皮肤损害出现，且会导致诊断混淆。可通过组织病理学、直接免疫荧光法（DIF）和间接免疫荧光法（IIF）进行诊断。口腔黏膜的DIF是一种侵入性操作，在严重黏膜溃疡患者中难以实施，并且研究表明BIOCHIP-IIF可用于检测天疱疮患者血清中的桥粒芯糖蛋白1和3。
目的
比较基于BIOCHIP嵌合体的IIF和口腔DIF在口腔黏膜天疱疮患者中的应用。
材料与方法
本研究纳入了所有经临床检查和组织病理学诊断为口腔黏膜天疱疮的病例。收集口腔DIF和BIOCHIP-IIF样本，并对结果进行分析。
结果
36例患者中，DIF阳性30例（83.3%），BIOCHIP-IIF阳性28例（77.8%）。将BIOCHIP-IIF与DIF进行比较，BIOCHIP的敏感性、特异性、阳性预测值和阴性预测值分别为80%、33.3%、85.71%和25%。卡方检验显示口腔DIF和BIOCHIP-IIF之间无统计学显著差异（ 值为0.5143）。在28例BIOCHIP阳性的患者中，27例（96.4%）显示桥粒芯糖蛋白（Dsg）3阳性，16例（57.1%）显示Dsg 1阳性。Dsg1的敏感性和特异性分别为53.3%和100%。Dsg3的敏感性和特异性分别为76.6%和33.3%。
结论
BIOCHIP-IIF可作为口腔黏膜天疱疮诊断中口腔DIF的替代方法。
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