Serin Gürdeniz, Karabulut Gonca, Kabasakal Yasemin, Kandiloğlu Gülşen, Akalin Taner
Department of Pathology, Buca Gynaecology, Obstetrics and Pediatrics Hospital, İZMİR, TURKEY.
Turk Patoloji Derg. 2016;32(2):65-9. doi: 10.5146/tjpath.2015.01346.
Minor salivary gland biopsy is one of the objective tests used in the diagnosis of Sjögren syndrome. The aim of our study was to compare the clinical and laboratory data of primary and secondary Sjögren syndrome cases with a lymphocyte score 3 and 4 in the minor salivary gland biopsy.
Data from a total of 2346 consecutive minor salivary gland biopsies were retrospectively evaluated in this study. Clinical and autoantibody characteristics of 367 cases with lymphocyte score 3 or 4 and diagnosed with primary or secondary Sjögren syndrome were compared.
There was no difference between lymphocyte score 3 and 4 primary Sjögren syndrome patients in terms of dry mouth, dry eye symptoms and Schirmer test results but Anti-Ro and Antinuclear Antibody positivity was statistically significantly higher in cases with lymphocyte score 4 (p= 0.025, p= 0.001). Anti-Ro test results were also found to be statistically significantly higher in secondary Sjögren syndrome patients with lymphocyte score 4 (p= 0.048).
In this study, the high proportion of cases with negative autoantibody but positive lymphocyte score is significant in terms of showing the contribution of minor salivary gland biopsy to Sjögren syndrome diagnosis. Lymphocyte score 3 and 4 cases were found to have similar clinical findings but a difference regarding antibody positivity in primary Sjögren syndrome. We believe that cases with lymphocyte score 4 may be Sjögren syndrome cases whose clinical manifestations are relatively established and higher autoantibody levels are therefore found.
小唾液腺活检是用于诊断干燥综合征的客观检查之一。我们研究的目的是比较小唾液腺活检中淋巴细胞评分为3和4的原发性和继发性干燥综合征病例的临床和实验室数据。
本研究回顾性评估了总共2346例连续的小唾液腺活检数据。比较了367例淋巴细胞评分为3或4且诊断为原发性或继发性干燥综合征患者的临床和自身抗体特征。
淋巴细胞评分为3和4的原发性干燥综合征患者在口干、眼干症状及泪液分泌试验结果方面无差异，但淋巴细胞评分为4的病例中抗Ro和抗核抗体阳性率在统计学上显著更高（p = 0.025，p = 0.001）。在淋巴细胞评分为4的继发性干燥综合征患者中，抗Ro试验结果在统计学上也显著更高（p = 0.048）。
在本研究中，自身抗体阴性但淋巴细胞评分阳性的病例比例较高，这对于显示小唾液腺活检对干燥综合征诊断的贡献具有重要意义。发现淋巴细胞评分为3和4的病例有相似的临床表现，但在原发性干燥综合征中抗体阳性情况存在差异。我们认为淋巴细胞评分为4的病例可能是临床表现相对典型且因此发现自身抗体水平较高的干燥综合征病例。
