Li Hong-Xia, Wang Ya-Fei, Zhou Ya-Xin, Feng Yuan, Wu Zhen-Biao
Department of Rheumatology and Immunology, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), No. 569 Xinsi Road, Baqiao District, Xi'an, 710038, Shaanxi, China.
Department of Rheumatology and Immunology, Air Force Medical Center, Air Force Medical University (Fourth Military Medical University), Beijing, China.
Rheumatol Ther. 2022 Oct;9(5):1347-1359. doi: 10.1007/s40744-022-00476-3. Epub 2022 Jul 22.
Non-specific chronic sialadenitis (NSCS) is a common pathology of labial salivary glands (LSGs), and NSCS with positive anti-SSA/SSB antibodies is common in clinical practice. Previous studies have evaluated the associations of high focus score (FS) with clinical manifestations in primary Sjögren's syndrome (pSS) patients extensively, but the characteristics of pSS with NSCS have seldom been investigated. We here analyzed the characteristics of pSS patients with NSCS.
Among 425 patients who underwent LSG biopsies, 217 had pSS and 37 non-SS sicca patients had NSCS without other diseases (i.e., sicca controls). We categorized these 217 pSS patients into three groups based on the pathology of LSGs: FS ≥ 1 (n = 104), 0 ≤ FS < 1 (n = 76), and NSCS (n = 37). We then compared the three groups while focusing on the NSCS group. Multivariate logistic regression analysis was performed to identify variables that influenced NSCS.
The mean age of pSS patients with NSCS (58.3 ± 11.0 years) was significantly higher than those with FS ≥ 1 (48.5 ± 14.9 years) and 0 ≤ FS < 1 (45.3 ± 13.7 years), but other clinical characteristics were similar. NSCS had a significant positive correlation with age (OR = 7.282, 95% CI 2.085-25.44 and OR = 13.130, 95% CI 3.368-51.189 for patients aged 45-64 years and > 65 years, respectively). Significantly higher levels of lymphocytic infiltration were found in the pSS NSCS group than in the sicca NSCS controls (48.6 vs. 10.8%, respectively).
The pSS patients with NSCS were older than corresponding non-NSCS pSS individuals, but they had similar clinical features. NSCS is associated with age and seldom occurred below the age of 45 years, regardless of the presence or absence of pSS. NSCS may be a subtype of pSS in elderly patients.
非特异性慢性涎腺炎(NSCS)是唇腺(LSGs)的常见病理表现,抗SSA/SSB抗体阳性的NSCS在临床实践中较为常见。以往研究广泛评估了原发性干燥综合征(pSS)患者高聚焦评分(FS)与临床表现的相关性,但pSS合并NSCS的特征鲜有研究。我们在此分析了pSS合并NSCS患者的特征。
在425例行唇腺活检的患者中,217例患有pSS,37例非干燥综合征的干燥症患者患有NSCS且无其他疾病(即干燥症对照组)。我们根据唇腺病理将这217例pSS患者分为三组:FS≥1(n = 104)、0≤FS<1(n = 76)和NSCS(n = 37)。然后我们比较这三组,重点关注NSCS组。进行多因素逻辑回归分析以确定影响NSCS的变量。
pSS合并NSCS患者的平均年龄(58.3±11.0岁)显著高于FS≥1组(48.5±14.9岁)和0≤FS<1组(45.3±13.7岁),但其他临床特征相似。NSCS与年龄呈显著正相关(45 - 64岁患者的OR = 7.282,95%CI 2.085 - 25.44;>65岁患者的OR = 13.130,95%CI 3.368 - 51.189)。pSS合并NSCS组的淋巴细胞浸润水平显著高于干燥症NSCS对照组(分别为48.6%和10.8%)。
pSS合并NSCS患者比相应的非NSCS pSS个体年龄更大,但他们具有相似的临床特征。NSCS与年龄相关,无论是否存在pSS,在45岁以下很少发生。NSCS可能是老年患者pSS的一种亚型。