The Research Of Adjunctive Examination In The Pathologic Diagnosis Of White Lesions Of Oral Mucosa

PURPOSE: To study the histochemical alteration of oral lichen planus, discoid lupus erythematosus and chronic hyperplastic candidiasis, to investigate the expression of immunoglobulins and complement in tissues of these oral mucosal diseases. To find easier and more effective methods which adjunctively examining white lesions of oral mucosa.METHODS: PAS stain, PASM stain, Masson stain and immunohistochemistry were applied to detect 20 oral lichen planus,19 discoid lupus erythematosus and 17 chronic hyperplastic candidiasis, normal oral mucosa specimens were used as control. Differences were observed, and the data was analyzed with statistical program.RESULTS: In OLP and DLE groups, the basement membrane changes included breaks,branches and disappearance by PAS and PASM stain, in CHC group, the majority of basement membrane were intact and continuous. The detected cases of fungal by PASM were significantly more than the cases of PAS stain(P<0.05).Masson stain showed the deposition of immune complex at the basement membrane zone (BMZ),there were significantly more cases of muscular atrophy in DLE group than OLP and CHC groups(P<0.05). There were obvious differences of immunoglobulins and complement positive rates in the BMZ and the histomonocytes in the connective tissue among the three groups (P<0.05),IgG, IgM, IgA,(or)C3 deposited at the BMZ of DLE group. Colloid bodies were positive staining by PAS, Masson and immunohistochemsitry.CONCLUSIONS:1. PASM stain is superior to PAS of detecting fungi.2. If there is no characteristic microabscess in epithelium, we can't negative diagnosis of fungal infection.3. There are considerable cases combined fungal infection in OLP and DLE.4. The atrophy of muscle fibers may be a reference of the diagnosis of DLE.5. There is an assistant meaning in differential diagnosis of white lesions of oral mucosa by applying immunohistochemistry to detect the immunoglobulins and complement.