Comparison of the American-European Consensus Group Sjogren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort.
Comparison of the American-European Consensus Group Sjogren's syndrome classification criteria to newly proposed American College of Rheumatology criteria in a large, carefully characterised sicca cohort.
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DOI：
10.1136/annrheumdis-2013-203845
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发表时间：
2014-01
影响因子：
27.4
通讯作者：
Sivils KL
中科院分区：
文献类型：
--
作者：
Rasmussen A;Ice JA;Li H;Grundahl K;Kelly JA;Radfar L;Stone DU;Hefner KS;Anaya JM;Rohrer M;Gopalakrishnan R;Houston GD;Lewis DM;Chodosh J;Harley JB;Hughes P;Maier-Moore JS;Montgomery CG;Rhodus NL;Farris AD;Segal BM;Jonsson R;Lessard CJ;Scofield RH;Sivils KL
考虑到不断努力解决系统中的差异和弱点，比较美国-欧洲共识小组 (AECG) 和美国风湿病学会 (ACR) 新提出的干燥综合征分类标准在充分表征的干燥队列中的表现。在一个评估干燥的多学科诊所中，我们评估了 646 名参与者的唾液腺和泪腺功能障碍以及自身免疫的特征，这些特征是通过对 646 名参与者进行 AECG 和 ACR 标准测试来定义的。对 180 名参与者的总体基因表达谱进行了比较。应用 AECG 和 ACR 标准分别对 279 名和 268 名 SS 参与者进行了分类。 244 名参与者 (81%) 满足这两项标准。在 35 名 AECG+/ACR- 参与者中，有 26 人的小唾液腺活检病灶评分≥1（74%），而 9 人的抗 Ro/La 呈阳性（26%）。有24名AECG-/ACR+符合ACR标准，主要是由于角膜染色评分的差异。所有 SS 患者，无论分类如何，都具有相似的基因表达谱，与健康对照不同。两组分类标准在大多数情况下产生一致的结果，并且基因表达谱表明，满足任一组标准的患者与其他 SS 参与者比与健康对照更相似。因此，从临床或生物学角度来看，没有明确的证据表明新的 ACR 标准比旧的 AECG 标准具有更高的价值。我们的观点是，在本报告的支持下，诊断敏锐性的提高将需要对致病机制有比目前更基本的了解。
To compare the performance of the American-European Consensus Group (AECG) and the newly proposed American College of Rheumatology (ACR) classification criteria for Sjögren's syndrome in a well-characterized sicca cohort, given ongoing efforts to resolve discrepancies and weaknesses in the systems. In a multidisciplinary clinic for the evaluation of sicca, we assessed features of salivary and lacrimal gland dysfunction and autoimmunity as defined by tests of both AECG and ACR criteria in 646 participants. Global gene expression profiles were compared in a subset of 180 participants. Application of the AECG and ACR criteria resulted in classification of 279 and 268 participants with SS, respectively. Both criteria were met by 244 participants (81%). In 26 of the 35 AECG+/ACR- participants, the minor salivary gland biopsy focal score was ≥1 (74%), while 9 had positive anti-Ro/La (26%). There were 24 AECG-/ACR+ who met ACR criteria mainly due to differences in the scoring of corneal staining. All patients with SS, regardless of classification, had similar gene expression profiles, which were distinct from the healthy controls. The two sets of classification criteria yield concordant results in the majority of cases and gene expression profiling suggests that patients meeting either set of criteria are more similar to other SS participants than to healthy controls. Thus, there is no clear evidence for increased value of the new ACR criteria over the old AECG criteria from the clinical or biological perspective. It is our contention, supported by this report, that improvements in diagnostic acumen will require a more fundamental understanding of the pathogenic mechanisms than is at present available.
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影响因子：
4.2
作者：
Whitcher, John P.;Shiboski, Caroline H.;Shiboski, Stephen C.;Maria Heidenreich, Ana;Kitagawa, Kazuko;Zhang, Shunhua;Hamann, Steffen;Larkin, Genevieve;McNamara, Nancy A.;Greenspan, John S.;Daniels, Troy E.
通讯作者：
Daniels, Troy E.
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
影响因子：
--
作者：
Daniels, Troy E.;Criswell, Lindsey A.;Shiboski, Caroline;Shiboski, Stephen;Lanfranchi, Hector;Dong, Yi;Schiodt, Morten;Umehara, Hisanori;Sugai, Susumu;Challacombe, Stephen;Greenspan, John S.
通讯作者：
Greenspan, John S.
影响因子：
12.8
作者：
Amador-Patarroyo, Manuel J.;Guillermo Arbelaez, Juan;Anaya, Juan-Manuel
通讯作者：
Anaya, Juan-Manuel