Pereira Débora-Lima, Vilela Verônica-Silva, Dos Santos Teresa-Cristina-Ribeiro-Bartholomeu, Pires Fábio-Ramôa
Oral Pathology, School of Dentistry, State University of Rio de Janeiro, Av. 28 de Setembro, 157, Vila Isabel - CEP: 20551-030, Rio de Janeiro/RJ - Brazil,
Med Oral Patol Oral Cir Bucal. 2014 May 1;19(3):e237-41. doi: 10.4317/medoral.19486.
Diagnosis of Sjögren's syndrome (SS) is complex and the usefulness of labial minor salivary glands biopsy in this process remains controversial.
to evaluate the clinical and laboratorial profile and histological features on labial minor salivary glands from patients under investigation of SS.
clinical charts from 38 patients under suspicion of SS and submitted to labial minor salivary glands biopsies were reviewed. Clinical and laboratorial data were retrieved from the clinical files and the HE-stained histological slides were reviewed under light microscopy.
mean age of the patients was 56.5 years and 97% were females; histological analysis showed that 42% of the cases showed ductal dilatation, lymphocytic foci were found in 52.6% and, from this group, 80% of the cases presented a foci/lobules ratio above 0.8. Acinar/ductal ratio was considered diminished in 39.5% of the samples. Thirty six (95%) and 32 (84%) patients, respectively, complained about xerostomia and xerophthalmia. A study of the time interval of the symptoms that led to SS investigation showed a mean of 116 months. Moreover, sixty-six percent of the patients had already been submitted to immunosuppressive therapy prior to the labial minor salivary gland biopsy. Age of the patients, scintigraphic alterations on salivary function, antinuclear factor (ANF), anti-Ro and anti-La did not show statistical significant association with the histological features. Lobules/foci ratio above 0.8 was the only histological parameter statistically associated with Sjögren's syndrome diagnosis (p<0.0001).
in the studied sample, lymphocytic foci on salivary glands were the only histological parameter associated to the diagnosis of SS. Early indication of labial minor salivary gland biopsy to patients under investigation of SS could limit the effects of immunosuppressive therapy on the histological features associated with the evolution of salivary gland involvement in SS.
干燥综合征（SS）的诊断较为复杂，唇腺活检在此过程中的作用仍存在争议。
评估疑似SS患者唇腺的临床、实验室检查特征及组织学特征。
回顾了38例疑似SS且接受唇腺活检患者的临床病历。从临床档案中获取临床和实验室数据，并在光学显微镜下观察苏木精-伊红（HE）染色的组织学切片。
患者的平均年龄为56.5岁，97%为女性；组织学分析显示，42%的病例出现导管扩张，52.6%发现淋巴细胞灶，其中80%的病例病灶/小叶比高于0.8。39.5%的样本腺泡/导管比降低。分别有36例（95%）和32例（84%）患者主诉口干和眼干。对导致SS检查的症状时间间隔进行研究，平均为116个月。此外，66%的患者在唇腺活检前已接受免疫抑制治疗。患者年龄、唾液功能闪烁扫描改变、抗核因子（ANF）、抗Ro和抗La与组织学特征无统计学显著关联。病灶/小叶比高于0.8是唯一与干燥综合征诊断有统计学关联的组织学参数（p<0.0001）。
在研究样本中，唾液腺淋巴细胞灶是与SS诊断相关的唯一组织学参数。对疑似SS患者尽早进行唇腺活检可限制免疫抑制治疗对与SS唾液腺受累演变相关的组织学特征的影响。
