Clinical characteristics and biopsy accuracy in suspected cases of Sjögren's syndrome referred to labial salivary gland biopsy.
Clinical characteristics and biopsy accuracy in suspected cases of Sjögren's syndrome referred to labial salivary gland biopsy.
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DOI：
10.1186/s12891-015-0482-9
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发表时间：
2015-02-15
影响因子：
2.3
通讯作者：
Valim V
中科院分区：
文献类型：
--
作者：
Giovelli RA;Santos MC;Serrano ÉV;Valim V
唇唾液腺活检（LSGB）是干燥综合征（SS）最重要的诊断手段，但对其诊断价值的研究很少。本研究评估了LSGB的敏感性和特异性，以及接受活检的患者的临床特征。对LSGB的组织病理学报告和2008年至2011年期间接受LSGB的患者的医学报告数据进行了回顾性分析。进行了约290次活检，74次因临床数据不足而被排除。216例患者中，丙型肝炎病毒携带者占0.46%，原发性SS（pSS）占30.1%，继发性SS（sSS）占8.8%。在这些样本中，94.3%出现干燥症状，51.6%仅出现干燥，42.7%有全身表现，66.9%出现低未刺激唾液流量和/或Schirmer试验。根据2002年美国-欧洲共识组（AECG）标准，67.6%的患者需要LSGB来确认SS的存在。以专家意见为依据，敏感性为86.57%，特异性为97.43%。阳性预测值（PPV）为95%，阴性预测值（NPV）为92.6%。测定准确率为93.3%。LSGB与专家意见的一致性（Kappa系数）为0.851，LSGB与AECG标准的一致性（Kappa系数）为0.806。在98例纤维肌痛和干燥的患者中，36.7%的SS和LSBG病灶评分≥ 1。SS患者年龄较大，表现出更严重的泪腺和唾液腺功能障碍，纤维肌痛，抗核抗体（ANA），抗SSA-Ro和抗SSB-La的频率更高。唇腺活检对pSS的诊断具有较高的敏感性、特异性、阳性预测值和阴性预测值。在临床实践中，它是有用的，特别是对那些腺体功能障碍和抗体阴性的患者。
Labial salivary gland biopsy (LSGB) is the most important diagnostic tool for the diagnosis of Sjögren’s syndrome (SS), but its diagnostic value is rarely studied. This study assessed the sensibility and specificity of LSGB, and the clinical profiles of patients who were referred for biopsy. Retrospective analysis of the histopathological reports from LSGB and medical report data from patients who underwent LSGB between 2008 and 2011 was conducted. About 290 biopsies were performed and 74 were excluded due to insufficient clinical data. Of the 216 patients, 0.46% was carrier of hepatitis C virus, 30.1% had primary SS (pSS), and 8.8% had secondary SS (sSS). Of the samples, 94.3% presented dryness symptoms, 51.6% experienced dryness only, 42.7% had systemic manifestations, and 66.9% presented low unstimulated salivary flow and/or Schirmer’s test. LSGB was necessary in 67.6% to confirm the presence of SS based on the American-European Consensus Group 2002 criteria (AECG). Based on specialist’s opinion, sensibility level was 86.57%, and specificity was 97.43%. Positive predictive value (PPV) was 95%, and negative predictive value (NPV) was 92.6%. Determined accuracy was 93.3%. Concordance (kappa coefficient) of LSGB and specialist’s opinion was 0.851, and LSGB with AECG criteria was 0.806. Of the 98 patients referred with fibromyalgia and dryness, 36.7% had SS and LSBG focus score of ≥ 1. Patients with SS were older, and showed more severe lachrymal and salivary dysfunctions, greater frequency of fibromyalgia, anti-nuclear antibodies (ANA), anti-SSA-Ro, and anti-SSB-La. Labial salivary gland biopsy has high sensibility, specificity, positive and negative predictive values for diagnosis of pSS. In the clinical practice, it is useful, especially for those patients with glandular dysfunctions and negative antibodies.
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影响因子：
2.1
作者：
Goransson, L. G.;Haldorsen, K.;Omdal, R.
通讯作者：
Omdal, R.
影响因子：
--
作者：
FOX, RI;ROBINSON, CA;HOWELL, FV
通讯作者：
HOWELL, FV
DOI：
10.1016/0030-4220(74)90417-4
发表时间：
1974-01-01
期刊：
ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTOLOGY
影响因子：
--
作者：
GREENSPAN, JS;DANIELS, TE;SYLVESTER, RA
通讯作者：
SYLVESTER, RA
DOI：
10.1002/art.23579
发表时间：
2008-05-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Caporali, Roberto;Bonacci, Eleonora;Montecucco, Carlomaurizio
通讯作者：
Montecucco, Carlomaurizio
影响因子：
--
作者：
Cornec, Divi;Jousse-Joulin, Sandrine;Devauchelle-Pensec, Valerie
通讯作者：
Devauchelle-Pensec, Valerie