Clinical Oral Investigations

, Volume 16, Issue 2, pp 565–570

Oral cGVHD screening tests in the diagnosis of systemic chronic graft-versus-host disease

  • Renata Gonçalves Resende
  • Jeane de Fátima Correia-Silva
  • Telma Cristina Arão
  • João Artur Ricieri Brito
  • Henrique Bittencourt
  • Ricardo Santiago Gomez
  • Mauro Henrique Nogueira Guimarães Abreu
Original Article

Abstract

To determine the diagnostic properties of oral manifestations and histological features of graft-versus-host disease (GVHD) screening tests in the diagnosis of systemic chronic graft-versus-host disease (cGVHD). Sixty patients having undergone allogeneic haematopoietic stem cell transplantation were selected. The patients were submitted to a clinical oral examination to assess symptoms and clinical changes in the oral mucosa. Histopathologic analysis of the lower lip oral mucosa (LLOM) and salivary glands (SG) was also performed. Systemic cGVHD was used for a comparison to oral cGVHD. The accuracy of oral cGVHD tests was low for all methods (58.4% and 52.6% for white lesions and white/red lesions, respectively, in the clinical analysis; 50.4% for the presence of oral pain; and 66.8% and 55.1% for LLOM and SG histopathologic tests, respectively). However, the presence of oral pain had good diagnostic properties [specificity: 100.0, 95% confidence interval (CI): 88.0–100.0; positive predictive value (PPV): 100.0, 95% CI: 94.4–100.0; and negative predictive value (NPV): 72.0, 95% CI: 57.3–83.3]. Moreover, SG alterations revealed by the histopathological analysis also exhibited good diagnostic properties (sensitivity: 98.6, 95% CI: 81.5–99.8; PPV: 71.1, 95% CI: 62.1–79.7; NPV: 85.9 95% CI: 32.9–99.4). The clinical severity of oral lesions and histophatological changes in the LLOM did not exhibit adequate diagnostic properties, whereas both oral pain and SG histopathological analysis exhibited adequate properties for the diagnosis of systemic cGVHD. Histological changes in lip oral mucosa and salivary glands together with a clinical manifestation of the disease in the oral mucosa can be useful to determining the systemic cGVHD.

Keywords

Haematopoietic stem cell transplantation Chronic graft-versus-host disease Oral chronic graft-versus-host disease 

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Renata Gonçalves Resende
    • 1
  • Jeane de Fátima Correia-Silva
    • 1
  • Telma Cristina Arão
    • 1
  • João Artur Ricieri Brito
    • 1
  • Henrique Bittencourt
    • 3
  • Ricardo Santiago Gomez
    • 1
  • Mauro Henrique Nogueira Guimarães Abreu
    • 2
    • 4
  1. 1.Department of Oral Surgery and PathologySchool of Dentistry, Universidade Federal de Minas GeraisBelo HorizonteBrazil
  2. 2.Department of Community and Preventive DentistrySchool of Dentistry, Universidade Federal de Minas GeraisBelo HorizonteBrazil
  3. 3.Stem Cell Transplant Unit, Hospital das ClínicasUniversidade Federal de Minas GeraisBelo HorizonteBrazil
  4. 4.Faculdade de Odontologia, Universidade Federal de Minas GeraisBelo HorizonteBrazil

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