Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications
Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications
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DOI：
10.1034/j.1600-0714.2003.00125.x
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发表时间：
2003-10-01
影响因子：
3.3
通讯作者：
van der Waal, I
中科院分区：
文献类型：
--
作者：
van der Meij, EH;van der Waal, I
导言：一般建议通过活检标本的组织病理学研究来确认口腔扁平苔藓(OLP)的临床诊断。然而，关于口腔扁平苔藓的临床和组织病理学诊断之间的相关性，几乎没有任何数据。本研究的目的是研究口腔扁平苔藓的临床和组织病理学评估之间的相关性，并提出适当的诊断改进。方法：使用先前发表的两项研究的临床和组织病理学数据。计算所有临床医生同意的临床病例数和所有评审病理学家同意的显微镜切片数，并相互比较，以评估临床病理相关性。结果：在42%的病例中，所有临床医生都同意临床诊断为口腔扁平苔藓的诊断，但在组织病理学诊断上似乎没有达成共识。相反，在所有病理医生都同意组织病理学诊断为口腔扁平苔藓的病例中，有50%的病例在临床诊断上缺乏共识。结论：根据本研究的结果，口腔扁平苔藓的诊断评估似乎缺乏临床病理相关性。因此，我们提出了一套修订的口腔扁平苔藓和口腔苔藓样病变的诊断标准，基于世卫组织对口腔扁平苔藓的定义，包括临床和组织病理学方面。
Introduction: Confirmation of a clinical diagnosis of oral lichen planus (OLP) by means of histopathologic study of a biopsy specimen is generally advised. However, hardly any data exist about the correlation between clinical and histopathologic diagnoses of OLP. The aim of the present investigation was to study the correlation between the clinical and histopathologic assessment of OLP, and to propose diagnostic refinements, if appropriate. Methods: Clinical and histopathologic data of two previously published studies were used for this purpose. The number of clinical cases in which all clinicians agreed as well as the number of microscopic slides on which all reviewing pathologists agreed were calculated and compared with each other in order to assess the clinicopathologic correlation. Results: In 42% of the cases in which all clinicians agreed about the clinical diagnosis being diagnostic of OLP, there appeared to be no consensus on the histopathologic diagnosis. Conversely, in 50% of the cases in which all pathologists agreed about the histopathologic diagnosis being diagnostic of OLP there was a lack of consensus on the clinical diagnosis. Conclusion: Based on the findings of the present study, there appears to be a lack of clinicopathologic correlation in the diagnostic assessment of OLP. We therefore propose a set of revised diagnostic criteria of OLP and oral lichenoid lesions, based on the WHO definition of OLP, including clinical as well as histopathologic aspects.