The diagnostic utility of submandibular gland sonography and labial salivary gland biopsy in IgG4-related dacryoadenitis and sialadenitis: Its potential application to the diagnostic criteria
The diagnostic utility of submandibular gland sonography and labial salivary gland biopsy in IgG4-related dacryoadenitis and sialadenitis: Its potential application to the diagnostic criteria
复制标题
颌下腺超声检查和唇唾液腺活检在 IgG4 相关泪腺炎和唾液腺炎中的诊断效用：其在诊断标准中的潜在应用
DOI：
10.1080/14397595.2019.1576271
复制
发表时间：
2019
影响因子：
2.2
通讯作者：
Nakamura Seiji
中科院分区：
文献类型：
--
作者：
Sakamoto Mizuki;Moriyama Masafumi;Shimizu Mayumi;Chinju Akira;Mochizuki Keita;Munemura Ryusuke;Ohyama Keiko;Maehara Takashi;Ogata Kenichi;Ohta Miho;Yamauchi Masaki;Ishiguro Noriko;Matsumura Mayu;Ohyama Yukiko;Kiyoshima Tamotsu;Nakamura Seiji
目的：在这项研究中，我们调查的诊断效用下颌下腺（SMG）超声检查和唇唾液腺（LSG）活检作为一种微创程序诊断IgG 4相关的泪腺炎和涎腺炎（IgG 4-DS）方法：68例疑似IgG 4-DS的肿胀，血清IgG升高（>1747 mg/dl）和/或肿胀的腺体进行SMG超声检查，LSG活检和血清IgG 4测量。SMG超声诊断确定了以下特征性的变化;“低回声区的结节模式与高血管”和/或“低回声区的网状模式在浅表parts. Results：31例患者被诊断为IgG 4-DS，5与IgG 4-RD不伴有泪腺和唾液腺病变，28与干燥综合征，4与恶性淋巴瘤。SMG超声和LSG活检诊断乳腺癌的敏感性、特异性和准确性分别为100%、83.8%、91.2%和64.5%、73.8%、75.0%。SMG超声和LSG活检结合血清IgG 4浓度（>135 mg/dl）的诊断率分别为100%、94.6%、97.1%和64.5%、91.9%、79.4%。SMG超声足以诊断IgG 4-DS，尤其是与血清学分析相结合时。因此，SMG超声作为一种无创性的检查方法，可以适应IgG 4-DS的诊断标准。
Objectives:In this study, we investigated the diagnostic utility of submandibular gland (SMG) sonography and labial salivary gland (LSG) biopsy as a less invasive procedure for diagnosing IgG4-related dacryoadenitis and sialadenitis (IgG4-DS)Methods:Sixty-eight patients with suspected IgG4-DS by presenting swelling of elevated serum IgG (>1747 mg/dl) and/or swelling glands underwent SMG sonography, LSG biopsy and measurement for serum IgG4. SMG sonographic diagnosis was determined by the following characteristic changes; ‘hypoechoic areas of a nodal pattern with high vascularity’ and/or ‘hypoechoic areas of a reticular pattern in the superficial part’.Results:Thirty-one patients were diagnosed with IgG4-DS, 5 with IgG4-RD unaccompanied by lacrimal and salivary gland lesions, 28 with Sjögren’s syndrome, and 4 with malignant lymphoma. The sensitivity, specificity, and accuracy of SMG sonography and LSG biopsy were 100%, 83.8%, 91.2% and 64.5%, 73.8%, 75.0%, respectively. Moreover, those of SMG sonography and LSG biopsy combined with serum IgG4 concentration (>135 mg/dl) were 100%, 94.6%, 97.1% and 64.5%, 91.9%, 79.4%, respectively.Conclusion:LSG biopsy needs to be extremely careful to diagnose IgG4-DS because of its low sensitivity. SMG sonography is sufficient for the diagnosis of IgG4-DS, especially when combined with serologic analysis. Thus, SMG sonography could adapt to the diagnostic criteria of IgG4-DS as a non-invasive method.