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一项前瞻性研究,比较唇部切口活检与腮腺切口活检在结节病、干燥综合征、涎腺肿大和淋巴瘤的检测与确诊中的应用。

A prospective study comparing incisional labial to incisional parotid biopsies in the detection and confirmation of sarcoidosis, Sjögren's disease, sialosis and lymphoma.

作者信息

Marx R E, Hartman K S, Rethman K V

机构信息

Division of Oral and Maxillofacial Surgery, University of Miami School of Medicine 33136.

出版信息

J Rheumatol. 1988 Apr;15(4):621-9.

PMID:3397971
Abstract

Simultaneous incisional biopsies of labial minor salivary glands and the superficial lobe of the parotid were accomplished in patients suspicious for sarcoidosis, Sjögren's disease, sialosis and lymphomatous changes in Sjögren's disease. Labial minor salivary gland biopsies identified sarcoidosis in 11 of 31 (36%) patients, compared to 29 of 31 (93%) patients using the parotid biopsy (p = 0.005). Similarly, the labial minor salivary gland biopsy confirmed 21 of 36 (58%) patients to have Sjögren's disease, compared to 36 of 36 (100%) (p = 0.005) patients confirmed using the parotid biopsy. Five patients with normal labial salivary gland biopsies were shown to have idiopathic hypertrophic sialosis with enlarged parotids identified by the parotid biopsy. Five additional patients were diagnosed with lymphoma occurring within the parotid glands of patients with Sjögren's disease, via the parotid biopsies, that were not identifiable with the labial minor salivary gland biopsy. The parotid biopsy consistently identified each disease entity in an earlier stage, and with more evident histopathology. Neither technique showed appreciable morbidity. Three of 77 patients showed a sensory loss related to labial salivary gland biopsy. No sensory or motor nerve loss was associated with the parotid biopsy.

摘要

对疑似结节病、干燥综合征、涎腺肿大症以及干燥综合征淋巴瘤样改变的患者,同时进行了唇小唾液腺和腮腺浅叶的切开活检。唇小唾液腺活检在31例患者中的11例(36%)确诊为结节病,而腮腺活检在31例患者中的29例(93%)确诊为结节病(p = 0.005)。同样,唇小唾液腺活检确诊36例患者中的21例(58%)患有干燥综合征,而腮腺活检确诊36例患者中的36例(100%)患有干燥综合征(p = 0.005)。5例唇唾液腺活检正常的患者经腮腺活检显示患有特发性肥大性涎腺肿大伴腮腺肿大。另外5例患者经腮腺活检诊断为干燥综合征患者腮腺内发生的淋巴瘤,唇小唾液腺活检未能识别。腮腺活检始终能在更早阶段识别每种疾病实体,且组织病理学表现更明显。两种技术均未显示明显的发病率。77例患者中有3例出现与唇唾液腺活检相关的感觉丧失。腮腺活检未出现感觉或运动神经损伤。

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