Assessing the Agreement of Light Microscopic Evaluation of Oral Lichen Planus Lesions With Associated Direct Immunofluorescence Evaluation

Authors

Blake T. Hansen, University of Nebraska Medical Center
Jeffrey B. Payne, University of Nebraska Medical CenterFollow
Kaeli Samson, University of Nebraska Medical CenterFollow
Peter J. Giannini, University of Nebraska Medical CenterFollow

Document Type

Article

Journal Title

Clinical Pathology

Publication Date

2023

Volume

16

Abstract

AIM/OBJECTIVE: Assess agreement between light microscopy and direct immunofluorescence (DIF) for histopathologic evaluation of oral lichen planus (OLP).

METHODS: Records evaluated included 60 OLP, 16 lichenoid mucositis (LM), and 56 non-OLP/non-LM cases. Cases had both light microscopic and DIF evaluations. Histopathologic parameters of OLP included: (1) hydropic degeneration of the basal cell layer, (2) band-like lymphocytic infiltrate immediately subjacent to the epithelium, and (3) presence of Civatte bodies. Two calibrated examiners independently assessed light microscopic features. Examiners reviewed cases with discordant diagnoses to determine a consensus diagnosis. Intra-rater reliability (IRR), sensitivity, specificity, positive, and negative predictive values (PPV and NPV) were determined.

RESULTS: Of 132 patients, 72.7% were female, average age 61.9 (SD = 13.8). Most common sites were gingiva (37.9%), buccal mucosa (37.1%), and tongue (7.6%). IRR was 0.74 (95% CI: 0.40, 1.00) for the consensus diagnosis and 0.73 (95% CI: 0.39, 1.00) and 0.34 (95% CI: -0.03, 0.72) for the 2 examiners. Comparing consensus and definitive diagnoses: sensitivity of light microscopy: 0.32 (95% CI: 0.20, 0.45); specificity: 0.88 (95% CI: 0.78, 0.94); PPV: 0.68 (95% CI: 0.48, 0.84), and NPV: 0.61 (95% CI: 0.51, 0.70).

CONCLUSION: Light microscopy alone is not a viable alternative to adjunctive DIF for diagnosis of OLP lesions.

DOI Link

10.1177/2632010X231197111

ISSN

2632-010X

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Recommended Citation

Hansen, Blake T.; Payne, Jeffrey B.; Samson, Kaeli; and Giannini, Peter J., "Assessing the Agreement of Light Microscopic Evaluation of Oral Lichen Planus Lesions With Associated Direct Immunofluorescence Evaluation" (2023). Journal Articles: College of Dentistry. 37.
https://digitalcommons.unmc.edu/cod_articles/37