A retrospective, multicenter study evaluating the prognostic value of minor salivary gland histology in a large cohort of patients with primary Sjogren's syndrome
A retrospective, multicenter study evaluating the prognostic value of minor salivary gland histology in a large cohort of patients with primary Sjogren's syndrome
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DOI：
10.1177/0961203314554251
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发表时间：
2015-03-01
期刊：
影响因子：
2.6
通讯作者：
Giacomelli, R.
中科院分区：
文献类型：
--
作者：
Carubbi, F.;Alunno, A.;Giacomelli, R.
目的探讨小涎腺(MSG)常规苏木精-伊红(H&E)染色对诊断原发性干燥综合征(PSS)的预后价值。H&E染色切片使用Chisholm和Mason分级系统和/或病灶评分(FS)。结果FS可以识别疾病谱中的一些差异，并通过二元Logistic回归量化FS值与临床/血清学变量之间的关系，进一步证实其预后作用。此外，在单变量分析中，低补体血症和FS是与淋巴瘤相关的唯一变量，而FS似乎与淋巴瘤独立相关，与补体组分浓度无关。相反，当根据Chisholm和Mason分级系统对患者进行分类时，我们没有观察到任何亚组之间的显著差异。结论除了其诊断作用外，我们的数据似乎支持常规的MSG-FS H&E染色评估有助于在诊断时预测不良结局，如淋巴瘤和腺外表现，这些不良结局使PSS病程复杂化。在此基础上，应建议即使在那些具有临床和血清学标准的患者中也应进行味精活检，从而使PSS的诊断独立于组织学状态。
Objective The objective of this report is to investigate the prognostic value of minor salivary glands (MSG) assessment, routinely performed with hematoxilin-eosin (H&E) staining, for the diagnosis of primary Sjogren's syndrome (pSS).Methods We retrospectively evaluated clinical, serological and histological features of 794 pSS patients. H&E-stained sections were assessed using the Chisholm and Mason grading system and/or the focus score (FS).Results FS allowed the identification of a number of differences in the disease spectrum, and its prognostic role was further confirmed by quantifying the association between FS value and clinical/serological variables with binary logistic regression. Moreover, hypocomplementemia and FS resulted the only variables associated with lymphoma at univariate analysis, and FS appeared to be associated with lymphoma independently on complement fraction concentrations. Conversely, when patients were divided according to the Chisholm and Mason grading system, we failed to observe any significant difference between subgroups.Conclusion In addition to its diagnostic role, our data seem to support that the routine assessment of MSG-FS with H&E staining is useful to predict at the time of diagnosis the adverse outcomes, such as lymphoma and extraglandular manifestations, that complicate the pSS course. On this basis, it should be recommended that an MSG biopsy be performed even in those patients displaying clinical and serological criteria, allowing the diagnosis of pSS independent of histological status.