Usefulness of Unstimulated and Stimulated Whole Saliva, Accuracy of Minor Labial Salivary Gland Biopsy in the Diagnosis of Primary Sjögren's Disease: A Croatian Single-Center, Cross-Sectional Study

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL

Galician Medical Journal Pub Date : 2023-09-01 DOI:10.21802/gmj.2023.3.4

Ivona Baric, A. Tadin, A. Glavina

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Abstract

The aim of this cross-sectional study was to determine the accuracy of minor labial salivary gland (MLSG) biopsy in the diagnosis of primary Sjögren' s disease (pSD); to study the correlation between the focus score (FS) and anti-SSA/Ro, anti-SSB/La, anti-SSA and -SSB antibodies, unstimulated whole saliva (UWS) and stimulated whole saliva (SWS); to determine the role of UWS and SWS in the clinical evaluation of pSD patients and patients with sicca symptoms. Methods. A total of 37 subjects were enrolled in the study and divided into two groups: the test group consisted of 15 patients diagnosed with pSD; the control group consisted of 22 patients who had sicca symptoms but did not meet the 2016 American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) diagnostic criteria. Clinical and laboratory tests, including saliva collection, MLSG biopsy, autoantibody titers, were performed in all patients. Results. The median of the FS was 1.00 [IQR=1.00-1.50] in the test group, whereas in the control group, it was 0.00 [IQR=0.00-0.00] (p< 0.001). The sensitivity, specificity, and accuracy of MLSG biopsy were 86.7%, 100.0%, and 94.6%, respectively. The results showed a correlation between the FS and antinuclear antibodies (ANA) (p=0.002). In addition, Pearson’s correlation showed a weak negative correlation between UWS (r=-0.058, p=0.73) and SWS (r=-0.022, p=0.90) and the FS. In the test group, 73.3% of patients had abnormal UWS values, while 86.7% had abnormal SWS values; among them, values of 0.00 ml/min for UWS and SWS were found in 60.0% and 26.7% of patients, respectively. Conclusions. Although MLSG biopsy has great diagnostic value and accuracy in diagnosing pSD, it is not always definitive. Our study found a statistically significant association between the FS and ANA, and the greater utility of SWS in diagnosing pSS.

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未刺激和刺激的全唾液的有用性，小唇唾液腺活检在原发性Sjögren疾病诊断中的准确性:克罗地亚单中心横断研究

这项横断面研究的目的是确定小唇唾液腺（MLSG）活检在诊断原发性干燥综合征（pSD）中的准确性；研究病灶评分（FS）与抗SSA/Ro、抗SSB/La、抗SSA和-SSB抗体、非刺激性全唾液（UWS）和刺激性全唾（SWS）的相关性；以确定UWS和SWS在pSD患者和有sicca症状的患者的临床评估中的作用。方法。共有37名受试者参加了这项研究，并分为两组：试验组由15名诊断为pSD的患者组成；对照组由22名有干燥症状但不符合2016年美国风湿病学会（ACR）和欧洲风湿病联盟（EULAR）诊断标准的患者组成。对所有患者进行了临床和实验室测试，包括唾液采集、MLSG活检、自身抗体滴度。后果试验组FS的中位数为1.00[IQR=1.00-1.50]，而对照组为0.00[IQR=0.000]（p<0.001）。MLSG活检的敏感性、特异性和准确性分别为86.7%、100.0%和94.6%。结果显示FS与抗核抗体（ANA）呈正相关（p=0.002）。此外，UWS（r=-0.058，p=0.73）和SWS（r==0.022，p=0.90）与FS呈弱负相关。在试验组中，73.3%的患者UWS值异常，而86.7%的患者SWS值异常；其中，UWS和SWS的值分别为0.00 ml/min的患者占60.0%和26.7%。结论。尽管MLSG活检在诊断pSD方面具有很高的诊断价值和准确性，但它并不总是决定性的。我们的研究发现FS和ANA之间存在统计学上显著的相关性，SWS在诊断pSS中的效用更大。

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来源期刊

Galician Medical Journal

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审稿时长

6 weeks