Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Unit of Dentistry and Oral Surgery, University of Pisa, Pisa, Italy.
Department of Clinical and Experimental Medicine, Unit of Rheumatology, University of Pisa, Pisa, Italy.
J Oral Pathol Med. 2021 May;50(5):485-491. doi: 10.1111/jop.13162. Epub 2021 Feb 15.
Sjögren's syndrome (SS) is an autoimmune disease characterized by an inflammatory infiltrate of exocrine salivary and lachrymal glands. Diagnosis is complex, and minor salivary gland biopsy and subsequent focus score (FS) calculation appear of extreme importance in the diagnostic work-up of the disease. Ultra-high frequency ultrasonography (UHFUS) is a recently introduced diagnostic technique, which is gaining an increasingly important role in intraoral imaging. This study aims at exploring the usefulness of UHFUS for obtaining valuable labial salivary gland samples to assess the histopathological features of SS patients.
Patients with clinical suspect of SS and eligible for minor salivary gland biopsy were enrolled. UHFUS scan of the lower lip was performed. Glandular echostructure was classified according to Outcome Measures in Rheumatology (OMERACT) scoring system. The glands to be sampled were selected on the basis of UHFUS evaluation and biopsied. The areas of the samples were recorded and compared with those obtained without UHFUS guidance. The correlation between UHFUS grade and labial gland FS was also assessed.
The areas of the samples obtained with UHFUS guidance were significantly higher (7.25 ± 3.98 mm ) than those obtained by conventional procedures (5.79 ± 3.49 mm , P = .02). UHFUS correlated significantly with the salivary gland FS (r = .532, P = .001).
UHFUS seems a promising tool in SS diagnostic algorithm, being able to provide a valuable support to the biopsy procedure. Further studies are mandatory to confirm the role of UHFUS in SS.
干燥综合征（SS）是一种自身免疫性疾病，其特征为外分泌唾液腺和泪腺的炎症浸润。诊断较为复杂，因此，在疾病的诊断过程中，对小唾液腺活检和随后的焦点评分（FS）计算显得尤为重要。超高频率超声（UHFUS）是一种最近引入的诊断技术，在口腔内成像中具有越来越重要的作用。本研究旨在探讨 UHFUS 用于获取有价值的唇唾液腺样本以评估 SS 患者的组织病理学特征的有效性。
纳入临床疑似 SS 且适合进行小唾液腺活检的患者。对下唇进行 UHFUS 扫描。根据疗效测量在风湿病学中的应用（OMERACT）评分系统对腺体回声结构进行分类。根据 UHFUS 评估选择要取样的腺体并进行活检。记录样本的面积，并与无 UHFUS 引导下获得的样本面积进行比较。还评估了 UHFUS 分级与唇腺 FS 之间的相关性。
在 UHFUS 引导下获得的样本面积明显高于常规程序（5.79±3.49mm，P=.02）（7.25±3.98mm）。UHFUS 与唾液腺 FS 显著相关（r=.532，P=.001）。
UHFUS 似乎是 SS 诊断算法中的一种有前途的工具，能够为活检程序提供有价值的支持。需要进一步的研究来证实 UHFUS 在 SS 中的作用。
