A scoring system for mucosal disease severity with special reference to oral lichen planus
A scoring system for mucosal disease severity with special reference to oral lichen planus
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DOI：
10.1111/j.1365-2133.2007.08106.x
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发表时间：
2007-10-01
影响因子：
10.3
通讯作者：
Challacombe, S. J.
中科院分区：
文献类型：
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作者：
Escudier, M.;Ahmed, N.;Challacombe, S. J.
背景 迄今为止，只有微弱的证据表明任何干预措施在缓解口腔扁平苔藓 (LP) 症状方面均优于安慰剂。需要开展涉及大型安慰剂对照、随机临床试验的进一步研究。这些需要仔细选择和标准化的结果测量。 目标 制定口内 LP 评分系统。 方法 对 156 名活检确诊的 LP 患者在第一次和后续就诊时根据 (i) 部位受累程度、(ii) 每个部位的疾病活动度和 (iii) 患者报告的总体疼痛评分进行评分。使用 Kruskal-Wallis 检验分析 LP 临床变异之间的总体差异，并使用 Mann-Whitney U 检验分析成对差异。通过对治疗前后的患者 (n = 23) 进行评分来评估临床敏感性（Wilcoxon 符号秩检验）。结果 网状 LP (n = 48) 是最常见的单一临床表现类型，其次是溃疡性 (n = 30)、萎缩性 (n = 22)、脱屑性 (n = 18) 和斑块性 (n = 1)。中位严重程度和活动评分为 13/6（网状）、39/20（溃疡）、20/9（萎缩）和 23/11（脱屑）。 37 例病例中发现两种或两种以上临床变异。当溃疡性 LP 与所有其他类型进行比较时，临床变异 (P < 0.0001) 和评分变异 (P < 0.01) 之间的差异具有统计学意义。临床敏感性具有统计学显着性（P < 0.01），而重现性很高，并且可以轻松评估对治疗的反应。结论表明该评分系统易于使用、重现性好且足够灵敏，足以检测对治疗的临床反应。
Background To date, there is only weak evidence for the superiority of any interventions over placebo for the palliation of symptomatic oral lichen planus (LP). Further research involving large placebo-controlled, randomized clinical trials is needed. These will require carefully selected and standardized outcome measures.Objectives To formulate a scoring system for intraoral LP.Methods One hundred and fifty-six patients with biopsy-confirmed LP were scored at the first and subsequent visits according to (i) extent of site involvement, (ii) disease activity at each site and (iii) an overall pain score as reported by the patient. Overall differences between clinical variants of LP were analysed using the Kruskal-Wallis test and pairwise differences by the Mann-Whitney U-test. Clinical sensitivity (Wilcoxon signed-rank test) was assessed by scoring patients before and after treatment (n = 23).Results Reticular LP (n = 48) was the commonest single type of clinical presentation, followed by ulcerative (n = 30), atrophic (n = 22), desquamative (n = 18) and plaque (n = 1). The median severity and activity scores were 13/6 (reticular), 39/20 (ulcerative), 20/9 (atrophic) and 23/11 (desquamative). Two or more clinical variants were seen in 37 cases. Statistical significance was observed for differences between clinical variants (P < 0.0001) and variation in scores (P < 0.01) when ulcerative LP was compared with all other types. Clinical sensitivity was statistically significant (P < 0.01), while reproducibility was high and allowed the response to therapy to be easily assessed.Conclusions It is suggested that this scoring system is easy to use, reproducible and sensitive enough to detect clinical responses to therapy.