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儿童小唾液腺活检对干燥综合征的诊断价值:一项为期10年的单中心回顾性研究

Diagnostic value of minor salivary gland biopsy for Sjögren's syndrome in children: A monocentric retrospective study over 10years.

作者信息

Adeline Fanny, Hittinger Ambre, Bolko Lois, Guettier Catherine, Kone-Paut Isabelle, Schvartz Adrien

机构信息

Department of Rheumatology, Maison-Blanche Hospital, Reims University Hospital, Reims, France; University of Reims Champagne-Ardennes, Reims, France.

Department of Rheumatology, Maison-Blanche Hospital, Reims University Hospital, Reims, France.

出版信息

Joint Bone Spine. 2025 May;92(3):105825. doi: 10.1016/j.jbspin.2024.105825. Epub 2024 Nov 26.

Abstract

OBJECTIVES

Minor salivary gland biopsy (MSGB) is a minimally invasive test used in suspected autoimmune diseases. Our study goal was to evaluate diagnostic performance of MSGB in children suspected of Sjögren's syndrome (SS).

METHODS

We did a retrospective monocentric study on patients under 18years old who had a MSGB between October 2011 and December 2021 at Bicêtre University Hospital. Biopsy was considered positive if focus score was positive or Chisholm-Mason score was superior to 2.

RESULTS

Sixty-six MSGB were analysed in SS indication, 23/66 (35%) were positive and 13/23 (57%) were associated with a confirmed final diagnosis. MSGB was sensitive and specific (Se=81%, Sp=80), but with low positive and negative predictive value (57% and 7%). Twenty of 64 MSGB also had positive anti-SSA antibodies. Anti-SSA antibodies improved MSGB specificity (98%).

CONCLUSION

MSGB demonstrates good sensitivity and specificity, but the predictive values and likelihood ratios make it a poor screening test. However, when combined with other criteria such as the presence of anti-SSA antibodies, the specificity of MSGB is improved. A larger prospective study should be carried out to support our results and clarify the good indications for MSGB.

摘要

目的

小唾液腺活检(MSGB)是一种用于疑似自身免疫性疾病的微创检查。我们的研究目的是评估MSGB在疑似干燥综合征(SS)儿童中的诊断性能。

方法

我们对2011年10月至2021年12月在比塞特尔大学医院接受MSGB检查的18岁以下患者进行了一项回顾性单中心研究。如果聚焦评分呈阳性或奇泽姆-梅森评分高于2,则活检被认为是阳性。

结果

对66例因SS指征进行的MSGB进行了分析,其中23/66(35%)为阳性,13/23(57%)与最终确诊相关。MSGB具有敏感性和特异性(Se=81%,Sp=80%),但阳性和阴性预测值较低(分别为57%和7%)。64例MSGB中有20例抗SSA抗体也呈阳性。抗SSA抗体提高了MSGB的特异性(98%)。

结论

MSGB显示出良好的敏感性和特异性,但预测值和似然比使其成为一种较差的筛查试验。然而,当与其他标准如抗SSA抗体的存在相结合时,MSGB的特异性会提高。应开展更大规模的前瞻性研究以支持我们的结果并明确MSGB的良好适应证。

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