Department of Rheumatology, EA 2216 Immunology and Pathology, SFR ScinBios, Labex Immunotherapy, Graft, Oncology, Brest University, Department of Odontology and Laboratory of Immunology and Immunotherapy, Brest Teaching Hospital, Brest, France. Department of Rheumatology, EA 2216 Immunology and Pathology, SFR ScinBios, Labex Immunotherapy, Graft, Oncology, Brest University, Department of Odontology and Laboratory of Immunology and Immunotherapy, Brest Teaching Hospital, Brest, France.
Department of Rheumatology, EA 2216 Immunology and Pathology, SFR ScinBios, Labex Immunotherapy, Graft, Oncology, Brest University, Department of Odontology and Laboratory of Immunology and Immunotherapy, Brest Teaching Hospital, Brest, France.
Rheumatology (Oxford). 2014 Sep;53(9):1604-7. doi: 10.1093/rheumatology/keu037. Epub 2014 Apr 4.
The aim of this study was to evaluate whether salivary gland ultrasonography (SGUS) improves the diagnostic performance of the 2012 ACR classification criteria for SS.
We studied a cohort of 101 patients with suspected SS seen at a single centre in Brittany, France. An SGUS echostructure score ≥2 was considered abnormal. The reference standard was a clinical diagnosis of SS made by a group of experts blinded to SGUS findings.
SS was diagnosed in 45 patients. Similar proportions of patients with and without SS had an ocular staining score ≥3. Adding RF positivity and ANA titre ≥1:320 as an alternative to anti-SSA/SSB positivity increased the sensitivity of the serological item without modifying specificity compared with using anti-SSA/SSB alone. SGUS was 60.0% sensitive and 87.5% specific for SS. Adding the SGUS score to the ACR criteria increased sensitivity from 64.4% to 84.4% and only slightly decreased specificity, from 91.1% to 89.3%.
The diagnostic performance of the ACR classification criteria for SS is notably improved by adding the SGUS score. SGUS should be included in future classification criteria for SS.
本研究旨在评估唾液腺超声（SGUS）是否能提高 2012 年 ACR 干燥综合征分类标准的诊断性能。
我们研究了在法国布列塔尼的一个单一中心就诊的 101 名疑似干燥综合征患者。SGUS 回声结构评分≥2 被认为是异常的。参考标准是一组专家做出的干燥综合征临床诊断，这些专家对 SGUS 结果不知情。
在 45 名患者中诊断出干燥综合征。有和没有干燥综合征的患者的眼部染色评分≥3 的比例相似。与单独使用抗 SS-A/SSB 相比，将 RF 阳性和 ANA 滴度≥1:320 作为抗 SS-A/SSB 阳性的替代物，提高了血清学项目的敏感性而不改变特异性。SGUS 对干燥综合征的敏感性为 60.0%，特异性为 87.5%。将 SGUS 评分添加到 ACR 标准中，敏感性从 64.4%提高到 84.4%，特异性仅略有下降，从 91.1%降至 89.3%。
通过添加 SGUS 评分，ACR 干燥综合征分类标准的诊断性能显著提高。SGUS 应纳入干燥综合征的未来分类标准中。
