Yazisiz Veli, Avci Ali Berkant, Erbasan Funda, Kiriş Evren, Terzioğlu Ender
Division of Rheumatology and Immunology, Department of Internal Medicine, University of Akdeniz, Antalya, Turkey.
Rheumatol Int. 2009 Feb;29(4):403-9. doi: 10.1007/s00296-008-0698-1. Epub 2008 Sep 18.
The aim of this study was to investigate the performance of minor salivary gland biopsy (MSGB), serological and clinical data in diagnosis of primary Sjögren's syndrome (pSS). Retrospective review of 216 patients who underwent minor labial salivary gland biopsy in last 5 years was performed. Results of the patients with diagnosis of pSS were compared with the patients failing to fill the classification criteria of pSS. Two groups did not differ significantly in terms of clinical symptoms and signs except presence of Raynaud's phenomenon. Specificity and positive likelihood ratio of clinical signs in diagnosis of pSS were quiet low. A total of 78.7% of pSS patients had a focus score >or=1 (Chiscolm's score III/IV) while all of the non-SS patients had a focus score <1 (P < 0.001). MSGB has the best predictive value with highest sensitivity and specificity for pSS diagnosis. Serological markers have higher predictive values compared to clinical symptoms and signs. Presence of Raynaud's phenomenon, lymphopenia and/or hypergammaglobulinemia strengthens the probability of pSS in a patient with sicca symptoms.
本研究旨在探讨小唾液腺活检（MSGB）、血清学及临床数据在原发性干燥综合征（pSS）诊断中的表现。对过去5年中接受唇小唾液腺活检的216例患者进行回顾性分析。将诊断为pSS的患者结果与未达pSS分类标准的患者进行比较。除雷诺现象外，两组在临床症状和体征方面无显著差异。pSS诊断中临床体征的特异性和阳性似然比相当低。78.7%的pSS患者焦点评分≥1（Chiscolm评分III/IV），而所有非干燥综合征（SS）患者焦点评分<1（P<0.001）。MSGB对pSS诊断具有最佳预测价值，敏感性和特异性最高。血清学标志物比临床症状和体征具有更高的预测价值。雷诺现象、淋巴细胞减少和/或高球蛋白血症会增加干燥症状患者患pSS的可能性。
