VEL Scope荧光系统在辅助诊断不同分型口腔扁平苔藓中的意义

Significance of VEL Scope Fluorescence System in Assisting Diagnosis of Different Types of Oral Lichen Planus

摘要: 目的：通过对比研究VEL scope荧光系统在不同分型的口腔扁平苔藓(Oral lichen planus, OLP)中的应用，评估其对辅助诊疗不同分型口腔扁平苔藓的准确性。方法：收集2019年9月至2021年8月就诊于徐州市中心医院口腔科，临床表现符合或疑似OLP的患者78例，纳入研究者75例，根据传统临床检查其中糜烂型51例，网纹型24例，所有患者知情同意后使用VEL scope荧光检查照射，选择VEL scope荧光下最暗区为活检位点(无明显暗区表现者依据临床检查选择临床表现最异常者为活检位点)进行活检手术。所有活检标本送检我院病理科，依据2003年WHO修订的OLP诊断标准，即组织病理学检查表现出固有层中大量的淋巴细胞聚集且呈典型带状浸润的同时可见基底细胞凋亡、液化变性，并且上皮层无任何异常增生改变，同时符合以上条件者确诊为OLP，收集数据并比较分析。结果：糜烂型中确诊者共45例(88.24%)，网纹型中确诊者共7例(29.17%)，所有患者在性别、年龄、发病部位等情况上无统计学差异。结论：研究表明网纹型确诊率明显低于糜烂型，VEL scope荧光系统对于糜烂型口腔扁平苔藓的确诊有重要的辅助诊断意义。

Abstract: Objective: The application of VEL scope fluorescence system in different types of oral lichen planus (OLP) was compared to evaluate its accuracy in auxiliary diagnosis and treatment of oral lichen planus. Methods: A total of 78 patients who were admitted to the Department of Stomatology of Xuzhou Central Hospital from September 2019 to August 2021 and whose clinical manifestations were consistent with or suspected of OLP were collected. 75 patients were included in the study. According to traditional clinical examination, 51 patients were of erosive type and 24 patients were of pattern type. The darkest area under the fluorescence of VEL scope was selected as the biopsy site (those with no obvious dark area manifestations were selected as the biopsy site with the most abnormal clinical manifestations according to the clinical examination) for biopsy operation. All biopsy specimens were in our department, for the conventional histopathological results back, according to the WHO in 2003 revision of the OLP diagnostic criteria, namely the histopathological examination showed that lymphocytes gather in large numbers in lamina propria and infiltrate a typical belt in visible basal cell’s withering, liquefied degeneration at the same time, and no abnormal growths on the cortex changer diagnosed with OLP. Those who met the above conditions were diagnosed as OLP. Data were collected and analyzed. Results: In erosion type, 45 cases (88.24%) were diagnosed, and in pattern type, 7 cases (29.17%) were diagnosed. There was no statistical difference in gender, age, and location of incidence among all patients. Conclusion: Studies have shown that the diagnosis rate of the reticulated type is significantly lower than that of the erosive type. The VEL scope fluorescence system has important auxiliary diagnostic significance for the diagnosis of the erosive type of oral lichen planus.