Department of Rheumatology, Affiliated Hospital of Zunyi Medical University, Huichuan District, 149 Dalian Road, Zunyi, 563003, Guizhou Province, China.
Clinical Medicine Department, Zunyi Medical University, Zunyi, 563003, China.
Clin Exp Med. 2024 Aug 6;24(1):175. doi: 10.1007/s10238-024-01428-7.
Labial salivary gland biopsy (LSGB) is one of the specific diagnostic criteria for primary Sjögren's syndrome (pSS). In traditional LSGB, there is no lower lip fixation device, the field of view is unclear due to intraoperative bleeding, and the incision is large, which is unfavourable for healing. The use of auxiliary devices to improve the shortcomings of traditional LSGB technique would be meaningful. Therefore, this case-control study aimed to assess the value of modified LSGB using chalazion forceps as compared with traditional LSGB. After obtaining written informed consent from all participating parents and patients, we randomly assigned 217 eligible participants to undergo LSGB using chalazion forceps (n = 125) or traditional LSGB (n = 92). The outcome variables were surgical time, incision length, intraoperative bleeding, pain score at 24 h after surgery, incision healing status at 7 days after surgery, gland collection, and pathological results. The final diagnostic results of the two surgical methods were compared, and the match rates between the pathological results and the final clinical diagnoses were compared between the two groups. The data were analysed using parametric and nonparametric tests. Compared with the traditional group, the modified group had a smaller incision, shorter operative time, less blood loss, lower 24 h pain score, and better Grade A incision healing at 7 days after surgery (p < 0.01). There was no statistically significant difference between the patients in the two surgical-method groups in terms of the positive biopsy results and the final diagnosis based on expert opinions (p > 0.05). By multivariable regression analysis, only a focus score (FS) of ≥ 1 (p < 0.01), dry eye disease (p < 0.05) and anti-nuclear antibodies (ANA) titre ≥ 1:320 (p < 0.05) were correlated with the diagnosis of pSS. The positive biopsy results of patients in the different surgical-method groups had a biopsy accuracy of > 80.0% for the diagnosis of pSS. The positive biopsy results in the different surgical-method groups were consistent with the expert opinions and the 2016 ACR-EULAR primary SS classification criteria. The modified LSGB using an auxiliary chalazion forceps offers a good safety with a small incision, shorter operative time, less bleeding, reduced pain and a low incidence of postoperative complications.The match rate of LSGB pathological results of the proposed surgical procedure with the final diagnosis of pSS is high.
唇腺活检（LSGB）是原发性干燥综合征（pSS）的特定诊断标准之一。在传统的 LSGB 中，没有下唇固定装置，由于术中出血视野不清楚，切口较大，不利于愈合。使用辅助装置来改善传统 LSGB 技术的缺点将是有意义的。因此，本病例对照研究旨在评估使用睑板腺夹的改良 LSGB 与传统 LSGB 相比的价值。在获得所有参与父母和患者的书面知情同意后，我们随机将 217 名符合条件的参与者分为接受睑板腺夹（n=125）或传统 LSGB（n=92）的 LSGB 组。观察指标为手术时间、切口长度、术中出血、术后 24 小时疼痛评分、术后 7 天切口愈合情况、腺体采集和病理结果。比较两种手术方法的最终诊断结果，并比较两组之间的病理结果与最终临床诊断的匹配率。使用参数和非参数检验进行数据分析。与传统组相比，改良组切口较小，手术时间较短，出血量较少，术后 24 小时疼痛评分较低，术后 7 天切口愈合 A 级较好（p<0.01）。两组患者的阳性活检结果和根据专家意见的最终诊断在统计学上无显著差异（p>0.05）。多变量回归分析显示，仅焦点评分（FS）≥1（p<0.01）、干燥眼病（p<0.05）和抗核抗体（ANA）滴度≥1:320（p<0.05）与 pSS 的诊断相关。不同手术方法组患者的阳性活检结果对 pSS 的诊断准确率>80.0%。不同手术方法组的阳性活检结果与专家意见和 2016 年 ACR-EULAR 原发性 SS 分类标准一致。使用辅助睑板腺夹的改良 LSGB 具有切口小、手术时间短、出血少、疼痛减轻和术后并发症发生率低的优点。所提出的手术程序的 LSGB 病理结果与 pSS 的最终诊断的匹配率较高。
