[Preliminary study on the significance of serum thyroid antibody in the selection of treatment for oral lichen planus].

Abstract

Objective: To investigate the efficacy of different treatment of oral lichen planus (OLP) patients with thyroid antibody positive and its correlation with thyroid antibody, providing more targeted treatment for OLP patients with thyroid antibody positive. Methods: Patients who were admitted to Department of Oral Medicine, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine for OLP with serum thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) from February 2020 to June 2024 were included. Demographic and clinical data were recorded, and qualitative status and quantitative titers of TPOAb/TGAb were collected. TPOAb and/or TGAb positive patients were included into the thyroid antibody positive group, while patients with both TPOAb and TGAb negative were included into the thyroid antibody negative group. According to the treatment methods, they were divided into topical treatment group, topical treatment combined with oral immunosuppressant group, and topical treatment combined with oral immunoenhancer group. After 2 weeks and 1 month of treatment, the clinical efficacy of thyroid antibody positive group and negative group in OLP patients under different treatment methods were compared, and the correlations of different clinical efficacy with age, sex and thyroid antibody titer were analyzed. Results: A total of 116 OLP patients were included in this study, of which 38 (32.8%) were thyroid antibody positive and 78 (67.2%) were thyroid antibody negative. Compared with untreated, the modified OLP score and pain degree in thyroid antibody negative group were significantly improved after 2 weeks and 1 month of topical treatment and topical treatment combined with oral immunosuppression (P<0.01). Although the thyroid antibody positive group also showed a remission trend, there was no statistical significance before and after treatment (P>0.05). For topical treatment combined with oral immunoenhancer, the modified OLP score and pain degree in both groups of antibody positive and negative were statistically significant different after 2 weeks and 1 month of treatment compared with before (P<0.01), while there was no statistically significant difference between the two groups (P>0.05). Multivariate Logistic regression analysis showed that the treatment efficacy of OLP in topical treatment group, topical treatment combined with oral immunosuppressant group, and topical treatment combined with oral immunoenhancer group had no significant correlation with age, sex, as well as the TPOAb and TGAb titer (P>0.05). Conclusions: Thyroid antibody TPOAb and TGAb could be reference factors for the selection of OLP treatment plan. For patients of OLP with positive thyroid antibodies, topical therapy combined with oral immunoenhancers may be preferred.