Direct Immunofluorescence in Oral Lichen Planus and Related Lesions: Sensitivity, Specificity, and Diagnostic Accuracy in a Single Diagnostic Center in Poland.

Objectives

Our study aimed to establish the basic reliability parameters of direct immunofluorescence test results in patients with oral lichen planus.

Methods

We conducted an evaluation of individual antibody classes in the DIF and ELISA (BP180 antigen), comparing these results with the classical histopathological (HP) examination in a group of patients treated within the standard healthcare in our clinic.

Results

Among 66 participants with oral changes indicative of LP, only 50% received histopathological confirmation of the LP diagnosis. Among those with a DIF profile entirely typical for LP (C3+, F+), 57.1% had a positive HP result. Fibrinogen deposits were identified in 42.4% and 36.4% of individuals with positive HP results for F1 and F2, respectively; 78.8% of patients with negative HP and 57.6% with positive HP exhibited no fibrinogen deposits. Simultaneous positivity for F1 and F2 occurred in all cases where F1 was positive. HP confirmed positive DIF for C3 in 50% of cases. Fibrinogen deposits demonstrated the highest diagnostic accuracy (61%). Sensitivity and specificity for fibrinogen deposits were 36% and 42% for F1 and 79% and 82% for F2. The positive predictive values were 67% for F1 and 67% for F2, while the negative predictive values were 58% for F1 and 56% for F2. Overall diagnostic accuracy was reported at 61% for F1 and 59% for F2.

Conclusions

Our data indicate the complementarity of HP and immunological test results and the necessity of using both methods together in cases of doubt.