扁平苔藓组织病理特征与临床表现的相关性分析  

Correlation analysis between pathological features and clinical manifestations of lichen planus

作　　者：张蕊娜[1] 钟珊[1] 梅雪岭[1] 王莉[1] ZHANG Rui-na;ZHONG Shan;MEI Xue-ling(Department of Dermatology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院皮肤科,北京100050

出　　处：《临床和实验医学杂志》2024年第14期1554-1559,共6页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨扁平苔藓组织病理变化与临床表现的相关性。方法回顾性分析2015年至2023年在首都医科大学附属北京友谊医院皮肤科就诊,且通过组织病理学检查确诊为扁平苔藓的病例。记录患者临床资料包括性别、年龄、病程、临床初步诊断,临床分型、病损范围、是否累及口腔、临床症状、伴随疾病;组织病理切片记录淋巴细胞浸润程度、基底细胞液化程度,色素失禁程度,其他浸润细胞,是否存在Civatte小体、是否有表皮下裂隙。采用非参数Kruskal-Wallis检验、Spearman秩相关分析、Kendall's Tau-b等级相关分析等方法,分析淋巴细胞浸润程度、基底细胞液化程度、Civatte小体与年龄、病程、病变范围、症状的相关性以及各病理特征之间的相关性。结果共收集204例患者,男性100例,女性104例;平均发病年龄52.5岁,平均病程4个月;病损部位累及口腔黏膜的有89例(43.6%)。病变范围仅累及1个部位的有77例(37.7%),累及2个部位的55例(27.0%),累及3个部位的25例(12.3%),累及3个部位以上的47例(23.0%)。204例患者中,初诊医师以“扁平苔藓”作为第1诊断的病例数114例(55.9%),作为第2诊断的病例数为27例(13.2%),临床未考虑扁平苔藓47例(23.0%)。伴随疾病中,其中111例(54.4%)患者无并随疾病,在伴随疾病中,一共涉及到65种疾病。淋巴细胞浸润程度与基底细胞液化程度呈正相关(r=0.514,P<0.05),淋巴细胞浸润程度、基底细胞液化程度与Civatte小体均呈正相关(r=0.230、0.153,P<0.05)。色素失禁程度与淋巴细胞浸润程度、基底细胞液化程度无相关性(均P>0.05)。病理与临床之间的相关性:淋巴细胞浸润程度与发病年龄、临床症状呈正相关(r=0.206、0.258,P<0.05),与病程、病变范围无相关性(均P>0.05);基底细胞液化程度与发病年龄、临床症状呈正相关(r=0.176、0.140,P<0.05),与病程呈负相关(r=-0.139,P<0.05),与病变范围无相关性(均P>0.05Objective To investigate the relationship between the histopathologic changes of lichen planus and related clinical factors.Methods A retrospective analysis was conducted on cases diagnosed with lichen planus through histopathological examination,who visited the Department of Dermatology,Beijing Friendship Hospital,Capital Medical University from 2015 to 2023.And the correlation between the intensity of lymphocytic infiltration,the intensity of basal layer liquefaction degeneration,Civatte bodies and age,disease course,lesion range,symptoms and the correlation between differnt pathological features were analyzed using non-parameter Kruskal-Wallis test,Spearman rank correlation analysis,Kendall's Tau-b rank correlation analysis.Results A total of 204 patients were collected,including 100 males and 104 females;The average age of onset was 52.5 years old,with an average course of 4 months;89 cases(43.6%)had lesions involving the oral mucosa.Seventy-seven cases(37.7%)affected only one site,55 cases(27.0%)affected two sites,25 cases(12.3%)affected three sites,and 47 cases(23.0%)affected more than three sites.Among the 204 patients,114 cases(55.9%)were initially diagnosed with"lichen planus"by the initial physician,while 27 cases(13.2%)were diagnosed with"lichen planus"as the second diagnosis.Forty-seven cases(23.0%)were not considered clinically.Among the accompanying diseases,111 cases(54.4%)had no accompanying diseases,and a total of 65 diseases were involved in the accompanying diseases.The intensity of lymphocytic infiltration was positively correlated with the intensity of basal layer liquefaction degensration(r=0.514,P<0.05),and both the intensity of lymphocytic infiltration and basal layer liquefaction degeneration were positively correlated with Civatte bodies(r=0.230,0.153;P<0.05).The intensity of pigment incontinence was unrelated with the intensity of lymphocytic infiltration and basal layer liquefaction degeneration(all P>0.05).Correlation between pathology and clinical:the intensity of lymphocytic infiltr

关 键 词：扁平苔藓 基底细胞液化 淋巴细胞浸润 瘙痒 

分 类 号：R758.65[医药卫生—皮肤病学与性病学]