Gao Liyan, Chen Huimin, Li Xin, Li Fangfei, Ou-Yang Qiaohong, Feng Tao
Center for Neurodegenerative Diseases, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Dongcheng District, Beijing, 100050, China.
Neurol Sci. 2015 Sep;36(9):1575-80. doi: 10.1007/s10072-015-2190-5. Epub 2015 Mar 28.
To investigate the predictive value of minor salivary gland biopsy in clinically diagnosed early stage Parkinson's disease (PD) patients, and to provide more evidence of minor salivary gland biopsy as a pathological diagnostic biomarker of PD. Thirteen patients with early stage PD and 13 age-matched controls were recruited. Hoehn and Yahr stage and Unified Parkinson's disease Rating Scale Part III were employed to evaluate their severity of the disease. All the subjects underwent minor salivary gland biopsy and (11)C-methyl-N-2β-carbomethoxy-3β-(4-fluorophenyl) tropane ((11)C-CFT) DAT-PET scan. Immunohistochemical staining for Lewy-type alpha-synucleinopathy using antibody against alpha-synuclein (α-Syn) was performed in the tissues obtained from minor salivary gland. Abnormal accumulation of α-Syn was found around the gland cells in 9 of the 13 patients with PD, but in none of the control subjects. The α-Syn immunoreactive structures were located in the periacinar space. Twelve clinically diagnosed PD patients showed asymmetrical and relatively severe reduction of (11)C-CFT uptake in the posterior putamen compared with the control. The sensitivity, specificity, positive predictive value and negative predictive value of minor salivary gland biopsy were 75, 100, 100 and 25%, respectively, when compared with the DAT-PET imaging. Our results suggest that minor salivary gland biopsy does not hold high diagnostic accuracy as DAT-PET, but still has the potential to be a useful pathologic biomarker for PD, which is worth more investigations.
为探讨小唾液腺活检对临床诊断的早期帕金森病（PD）患者的预测价值，并为小唾液腺活检作为PD的病理诊断生物标志物提供更多证据。招募了13例早期PD患者和13例年龄匹配的对照。采用 Hoehn 和 Yahr 分期以及统一帕金森病评定量表第三部分来评估疾病严重程度。所有受试者均接受小唾液腺活检和（11）C-甲基-N-2β-甲氧羰基-3β-（4-氟苯基）托烷（（11）C-CFT）多巴胺转运体正电子发射断层扫描（DAT-PET）。对从小唾液腺获取的组织进行使用抗α-突触核蛋白（α-Syn）抗体的路易体型α-突触核蛋白病免疫组织化学染色。13例PD患者中有9例在腺细胞周围发现α-Syn异常积聚，而对照受试者中均未发现。α-Syn免疫反应性结构位于腺泡周围间隙。与对照相比，12例临床诊断的PD患者在壳核后部的（11）C-CFT摄取显示不对称且相对严重降低。与DAT-PET成像相比，小唾液腺活检的敏感性、特异性、阳性预测值和阴性预测值分别为75%、100%、100%和25%。我们的结果表明，小唾液腺活检不像DAT-PET那样具有高诊断准确性，但仍有潜力成为PD的有用病理生物标志物，值得进一步研究。
