Markkanen S O, Syrjänen S M, Lappalainen R, Markkanen H
Department of Electron Microscopy, University of Kuopio, Finland.
Appl Pathol. 1989;7(4):233-40.
Biopsy of the minor salivary glands is an accepted method in the diagnosis of Sjögren's syndrome, the most characteristic feature being the prominent inflammatory cell infiltration. However, difficulties exist in the early diagnosis of Sjögren's syndrome. The present study was conducted to analyse by subjective and quantitative methods the morphological changes of the salivary glands in patients with rheumatoid arthritis (RA) frequently complicated by Sjögren's syndrome. The subjects of this study were 71 RA patients (mean age 54 +/- 15 years) and their 45 healthy age-matched controls (mean age 60 +/- 14 years). The histologic parameters evaluated were: inflammatory cell infiltration; acinar atrophy; fibrosis, and fatty infiltration. Statistically significant differences between the RA and the control groups were found in all parameters (p less than 0.001) except the fatty infiltration. This indicates that destruction of the salivary glands including fibrosis and acinar atrophy is associated with RA. Only the fatty infiltration seems to be an age-dependent change. All salivary gland biopsies of the RA patients were photographed and evaluated planimetrically, for the same parameters as in the subjective evaluation. An excellent reproducibility between the two methods was found, thus indicating the applicability of the subjective evaluation in the assessment of early salivary gland changes in RA patients.
小唾液腺活检是诊断干燥综合征公认的方法，其最典型的特征是显著的炎性细胞浸润。然而，干燥综合征的早期诊断存在困难。本研究旨在通过主观和定量方法分析类风湿关节炎（RA）患者常并发干燥综合征时唾液腺的形态学变化。本研究的对象为71例RA患者（平均年龄54±15岁）及其45例年龄匹配的健康对照者（平均年龄60±14岁）。评估的组织学参数包括：炎性细胞浸润；腺泡萎缩；纤维化和脂肪浸润。除脂肪浸润外，RA组与对照组在所有参数上均存在统计学显著差异（p<0.001）。这表明包括纤维化和腺泡萎缩在内的唾液腺破坏与RA有关。只有脂肪浸润似乎是一种与年龄相关的变化。对所有RA患者的唾液腺活检标本进行拍照，并对与主观评估相同的参数进行平面测量评估。发现两种方法之间具有极好的重复性，从而表明主观评估在评估RA患者早期唾液腺变化中的适用性。
